Provider Demographics
NPI:1922191006
Name:SEWITSKY, AIMEE RENEE (SLP)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:RENEE
Last Name:SEWITSKY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:RENEE
Other - Last Name:HENDRICKS
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2010 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1599
Mailing Address - Country:US
Mailing Address - Phone:570-963-1278
Mailing Address - Fax:570-963-1292
Practice Address - Street 1:2010 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1599
Practice Address - Country:US
Practice Address - Phone:570-963-1278
Practice Address - Fax:570-963-1292
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013777610001Medicaid
PA161721Medicare UPIN