Provider Demographics
NPI:1891128294
Name:LETIZIA, ROSA (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:
Last Name:LETIZIA
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:MS
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:DAVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, TSSLD
Mailing Address - Street 1:7367 217TH ST
Mailing Address - Street 2:APT. B
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2933
Mailing Address - Country:US
Mailing Address - Phone:646-226-3301
Mailing Address - Fax:
Practice Address - Street 1:3000 W 1ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3702
Practice Address - Country:US
Practice Address - Phone:646-226-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist