Individual
MS. DIANE J WISINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1324 W 36TH ST, ERIE, PA 16508-2450
(814) 864-2919
Mailing address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-3108
(814) 877-2653
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL 000120
PA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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