Provider Demographics
NPI:1568653467
Name:SIMONYAN, EVELINA (MHS, CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:EVELINA
Middle Name:
Last Name:SIMONYAN
Suffix:
Gender:F
Credentials:MHS, CCC-SLP/L
Other - Prefix:
Other - First Name:EVELIN
Other - Middle Name:
Other - Last Name:PIROGOVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15103 AMHERST GREEN CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-6009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15103 AMHERST GREEN CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-6009
Practice Address - Country:US
Practice Address - Phone:847-638-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008894235Z00000X
MO2022006727235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist