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Individual

MS. DIANE MARIE LASECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
1275 LAKESIDE AVE E, CLEVELAND, OH 44114-1132
(216) 736-2612
(216) 241-8230
Mailing address
3645 W 104TH ST, CLEVELAND, OH 44111-3818
(216) 341-3885
(216) 941-3885

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA01684
OH

Other

Enumeration date
02/26/2007
Last updated
07/08/2007
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