| Doctor Name: | KATHLEEN MARY ANESKO |
| NPI Number: | 1891948956 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 009978-1 |
| Business Practice Address: | 619 Maple St Rivervale, NJ - 076756549 |
| Business Phone Number: | 2019300435 |
| Business Fax Number: | 2019300435 |
| Mailing Address: | 619 Maple St, RIVERVALE |
| State: | NJ |
| Postal Code: | 076756549 |
| Phone Number: | 2019300435 |
| Fax Number: | 2019300435 |
| NPI Enumeration Date: | 11/02/2008 |
| NPI Last Update Date: | 11/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 009978-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |