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NPI Code Detail

MEDICARE: LISA ANN VISNESKI MS, CCC-SLP

MEDICARE: LISA ANN VISNESKI MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSL010069PA

General Provider Information

NPI Number : 1477850717
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN VISNESKI MS, CCC-SLP
Provider Business Mailing Address
First Line : 301 LAKE ST # 370
Second Line :
City : DALLAS
State : PA
Zip : 18612-7752
Country : US
Telephone Number : 570-266-2920
Fax Number :
Provider Business Practice Location Address
First Line : 301 LAKE ST # 370
Second Line :
City : DALLAS
State : PA
Zip : 18612-7752
Country : US
Telephone Number : 570-266-2920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 05/22/2020

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Directions to “ LISA ANN VISNESKI MS, CCC-SLP” Practice Location

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