Provider Demographics
NPI:1205272689
Name:KLOSINSKA-SALAZAR, ANNA KATARZYNA (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:KATARZYNA
Last Name:KLOSINSKA-SALAZAR
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 MAIN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-2122
Mailing Address - Country:US
Mailing Address - Phone:860-573-8005
Mailing Address - Fax:
Practice Address - Street 1:931 MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073-2122
Practice Address - Country:US
Practice Address - Phone:860-573-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist