Provider Demographics
NPI:1043512346
Name:VISLOSKY, KAREN M
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:VISLOSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:VISLOSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:374 ALVERDA RD
Mailing Address - Street 2:
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-7802
Mailing Address - Country:US
Mailing Address - Phone:724-840-6158
Mailing Address - Fax:
Practice Address - Street 1:IDA TOWERS
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3411
Practice Address - Country:US
Practice Address - Phone:724-840-6158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1279021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical