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General NPI Number Information
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NPI Number | 1053676460
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Entity Type | Individual
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Provider Name | CARALYN M WASNEECHAK M.S. SLP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 1421 KRISTINA WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23320-8917
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Country | US
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Telephone | 315-272-5771
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Fax |
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Provider Business Mailing Address
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Address Line | 717 SHADOWFIELD CT
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City | CHESAPEAKE
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State | VA
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Zip | 23322-5873
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Country | US
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Telephone | 315-272-5771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202009207
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 022003-1
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License Number State | NY
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