Individual
ANDRIA DALLEY FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1101 VINE STREET, SCRANTON, PA 18510-2126
(570) 343-7175
Mailing address
301 LAKE ST, DALLAS, PA 18612-7752
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL012662
PA
Other
Enumeration date
12/31/2015
Last updated
10/23/2017
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