Individual
LISA MARIE WASELESKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3525 STATE ROUTE 183, ROOTSTOWN, OH 44272-9797
(330) 524-5538
Mailing address
3525 STATE ROUTE 183, ROOTSTOWN, OH 44272-9797
(330) 524-5538
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6700510
—
OH
Enumeration date
10/05/2020
Last updated
10/05/2020
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