Provider Demographics
NPI:1306038443
Name:YAMPOLSKY, ALEKSANDRA (SCD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDRA
Middle Name:
Last Name:YAMPOLSKY
Suffix:
Gender:F
Credentials:SCD
Other - Prefix:DR
Other - First Name:SASHA
Other - Middle Name:
Other - Last Name:YAMPOLSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1410 HIGHLAND AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2671
Mailing Address - Country:US
Mailing Address - Phone:781-492-3572
Mailing Address - Fax:
Practice Address - Street 1:1410 HIGHLAND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2671
Practice Address - Country:US
Practice Address - Phone:781-492-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4615235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist