Provider Demographics
NPI:1467698787
Name:LIAKOS, VASILIKI (MS SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:VASILIKI
Middle Name:
Last Name:LIAKOS
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 CORNELL ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2803
Mailing Address - Country:US
Mailing Address - Phone:617-325-5263
Mailing Address - Fax:
Practice Address - Street 1:346 CORNELL ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-2803
Practice Address - Country:US
Practice Address - Phone:617-325-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-7620-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist