Provider Demographics
NPI:1861695504
Name:TOMKIEWICZ, CAROL (MS)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:TOMKIEWICZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CONYNGHAM DRUMS ROAD
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF
Mailing Address - State:PA
Mailing Address - Zip Code:18249-3114
Mailing Address - Country:US
Mailing Address - Phone:570-788-4510
Mailing Address - Fax:
Practice Address - Street 1:73 CONYNGHAM DRUMS ROAD
Practice Address - Street 2:
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249-3114
Practice Address - Country:US
Practice Address - Phone:570-788-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000299L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist