Provider Demographics
NPI:1306352174
Name:ROSSETTI, MONIKA SAPPHIRE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:SAPPHIRE
Last Name:ROSSETTI
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 BLUEGRASS LN
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7124
Mailing Address - Country:US
Mailing Address - Phone:479-459-5423
Mailing Address - Fax:
Practice Address - Street 1:3400 COTTAGE WAY STE G2
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1474
Practice Address - Country:US
Practice Address - Phone:479-459-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSP5959235Z00000X
CASP27462235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist