Doctor Name: | MS. SUSAN EILEEN WISNIEWSKI |
NPI Number: | 1164716098 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP/L |
License Number: | SL005451L |
Business Practice Address: | 4728 Lake Pleasant Rd Erie, PA - 165042778 |
Business Phone Number: | 8148250000 |
Business Fax Number: | 8148253920 |
Mailing Address: | 4728 Lake Pleasant Rd, ERIE |
State: | PA |
Postal Code: | 165042778 |
Phone Number: | 8148250000 |
Fax Number: | 8148253920 |
NPI Enumeration Date: | 06/08/2011 |
NPI Last Update Date: | 06/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL005451L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |