Provider Demographics
NPI:1861224255
Name:OMIECINSKI, ANNA ISABEL (CF-SLP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ISABEL
Last Name:OMIECINSKI
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27645 BISHOP PARK DR APT 621
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092-3073
Mailing Address - Country:US
Mailing Address - Phone:440-251-5423
Mailing Address - Fax:
Practice Address - Street 1:60 WOOD ST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3332
Practice Address - Country:US
Practice Address - Phone:440-352-0788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist