Provider Demographics
NPI:1407210040
Name:SLOVIKOSKY, ANASTASIA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:
Last Name:SLOVIKOSKY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MONOCACY CIR
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2247
Mailing Address - Country:US
Mailing Address - Phone:410-599-4095
Mailing Address - Fax:
Practice Address - Street 1:17 MONOCACY CIR
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2247
Practice Address - Country:US
Practice Address - Phone:410-599-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-10
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04726235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist