Provider Demographics
NPI:1427011717
Name:CASLOW, TISA M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:TISA
Middle Name:M
Last Name:CASLOW
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 COMMUNITY WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2301
Mailing Address - Country:US
Mailing Address - Phone:717-393-0425
Mailing Address - Fax:717-392-7107
Practice Address - Street 1:625 COMMUNITY WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2301
Practice Address - Country:US
Practice Address - Phone:717-393-0425
Practice Address - Fax:717-392-7107
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL00587SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist