Provider Demographics
NPI:1346409349
Name:SERAFIN, AGNIESZKA (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:SERAFIN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:AGNIESZKA
Other - Middle Name:
Other - Last Name:ROGOWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 TOWLE DR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1266
Mailing Address - Country:US
Mailing Address - Phone:508-829-0449
Mailing Address - Fax:
Practice Address - Street 1:22 GRANT RD
Practice Address - Street 2:
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434-4468
Practice Address - Country:US
Practice Address - Phone:978-772-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6558235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist