Provider Demographics
NPI:1184516395
Name:POLANSKY, NICOLE TAYLOR (AUD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:TAYLOR
Last Name:POLANSKY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 BOYLSTON ST STE 303
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2115
Mailing Address - Country:US
Mailing Address - Phone:617-383-6830
Mailing Address - Fax:
Practice Address - Street 1:1244 BOYLSTON ST STE 303
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2115
Practice Address - Country:US
Practice Address - Phone:617-383-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAUD100214231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist