Provider Demographics
NPI:1538393186
Name:ANUSZKIEWICZ, THOMAS M (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:ANUSZKIEWICZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 WOODLEDGE DRIVE
Mailing Address - Street 2:MARION PSYCHOLOGICAL INC.
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5913
Mailing Address - Country:US
Mailing Address - Phone:330-379-1281
Mailing Address - Fax:330-867-0623
Practice Address - Street 1:702 WOODLEDGE DRIVE
Practice Address - Street 2:MARION PSYCHOLOGICAL INC.
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5913
Practice Address - Country:US
Practice Address - Phone:330-379-1281
Practice Address - Fax:330-867-0623
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3543103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical