Doctor Name: | MS. ANASTASIA ANTONIADIS |
NPI Number: | 1922439819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC/SLP |
License Number: | SL002379L |
Business Practice Address: | 62 Old Forge Xing Devon, PA - 193331119 |
Business Phone Number: | 6102029060 |
Business Fax Number: | |
Mailing Address: | 62 Old Forge Xing, DEVON |
State: | PA |
Postal Code: | 193331119 |
Phone Number: | 6102029060 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2013 |
NPI Last Update Date: | 01/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL002379L |
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 |