Provider Demographics
NPI:1992009187
Name:GIORGIS, TANIA L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:L
Last Name:GIORGIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:
Other - Last Name:EGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:194 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1942
Mailing Address - Country:US
Mailing Address - Phone:585-271-4583
Mailing Address - Fax:
Practice Address - Street 1:194 FIELD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1942
Practice Address - Country:US
Practice Address - Phone:585-271-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014842-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist