Provider Demographics
NPI:1578801015
Name:WISNIEWSKI, KERA L (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KERA
Middle Name:L
Last Name:WISNIEWSKI
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 1:4035 GREEN POND RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9662
Mailing Address - Country:US
Mailing Address - Phone:610-867-2515
Mailing Address - Fax:
Practice Address - Street 1:4035 GREEN POND RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9662
Practice Address - Country:US
Practice Address - Phone:610-867-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist