Individual
MRS. ANN MARIE MILEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC, NYS LIC.
Contact information
Practice address
11 ELM ST, PHOENIX, NY 13135-1922
(315) 695-1561
Mailing address
8338 DATUM LN, BALDWINSVILLE, NY 13027-6201
(315) 695-1561
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006666-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006666-1
NY STATE LICENSE
NY
01
—
01095478
ASHA CERTIFICATION
—
Enumeration date
09/09/2010
Last updated
09/09/2010
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