Provider Demographics
NPI:1518165893
Name:KASMIROSKI, ROBERTA ANN (SLP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANN
Last Name:KASMIROSKI
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 1:2051 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5122
Mailing Address - Country:US
Mailing Address - Phone:610-317-0128
Mailing Address - Fax:
Practice Address - Street 1:634 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6362
Practice Address - Country:US
Practice Address - Phone:610-625-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005169L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist