Individual
ANITA LOUISE WASILESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
400 E 2ND ST, CENTENNIAL HALL, BLOOMSBURG, PA 17815-1301
(570) 389-5380
(570) 389-5022
Mailing address
400 E 2ND ST, CENTENNIAL HALL, BLOOMSBURG, PA 17815-1301
(570) 389-5380
(570) 389-5022
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL000960L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008477920001
—
PA
Enumeration date
10/23/2006
Last updated
07/09/2007
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