Provider Demographics
NPI:1437833126
Name:JASIENSKA, ALEKSANDRA AGNIESZKA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:AGNIESZKA
Last Name:JASIENSKA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 WILLIAMSON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8191
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:364 S HWY 16
Practice Address - Street 2:STE 200
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164
Practice Address - Country:US
Practice Address - Phone:704-746-9698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist