Individual
MS. ANASTASIA ANTONIADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
62 OLD FORGE XING, DEVON, PA 19333-1119
(610) 202-9060
Mailing address
62 OLD FORGE XING, DEVON, PA 19333-1119
(610) 202-9060
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL002379L
PA
Other
Enumeration date
12/03/2013
Last updated
01/03/2014
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