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Individual

ELIZABETH ANNE YASICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
17609 VENTURA BLVD, SUITE 215, ENCINO, CA 91316-3858
(818) 501-8352
Mailing address
17609 VENTURA BLVD, SUITE 215, ENCINO, CA 91316-3858
(818) 501-8352

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21249
CA
235Z00000X
Speech-Language Pathologist
3686-154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
272115023
PRIVATE PRACTICE
CA
Enumeration date
07/24/2012
Last updated
08/29/2013
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