Provider Demographics
NPI:1578327532
Name:ANUSZEWSKI, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ANUSZEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-2124
Mailing Address - Country:US
Mailing Address - Phone:570-309-9555
Mailing Address - Fax:
Practice Address - Street 1:5626 ROUTE 115
Practice Address - Street 2:
Practice Address - City:BLAKESLEE
Practice Address - State:PA
Practice Address - Zip Code:18610-7926
Practice Address - Country:US
Practice Address - Phone:570-309-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL017462235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist