Provider Demographics
NPI:1437762606
Name:VASILOFF, REGINA ELLEN (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:ELLEN
Last Name:VASILOFF
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5837 IVY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6351
Mailing Address - Country:US
Mailing Address - Phone:614-906-2402
Mailing Address - Fax:
Practice Address - Street 1:5837 IVY BRANCH DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-6351
Practice Address - Country:US
Practice Address - Phone:614-906-2402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.03578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist