Individual
JANICE ANASTASIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
920 S 4TH ST, LOUISVILLE, KY 40203-3206
(502) 560-5182
Mailing address
629 RIDGEWOOD DR, DAPHNE, AL 36526-7707
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
267651
KY
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609276245
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
09/26/2018
Last updated
01/04/2021
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