Provider Demographics
NPI:1093514820
Name:VASSILTSOVA, OXANA
Entity type:Individual
Prefix:
First Name:OXANA
Middle Name:
Last Name:VASSILTSOVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WAYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3622
Mailing Address - Country:US
Mailing Address - Phone:774-452-4703
Mailing Address - Fax:
Practice Address - Street 1:39 WAYSIDE RD
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3622
Practice Address - Country:US
Practice Address - Phone:774-452-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health