Provider Demographics
NPI:1598161895
Name:RAPOSO-SACKS, ELLA (AUD)
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:RAPOSO-SACKS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 MAIN ST # 983
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3990
Mailing Address - Country:US
Mailing Address - Phone:781-246-0305
Mailing Address - Fax:
Practice Address - Street 1:979 MAIN ST # 983
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3990
Practice Address - Country:US
Practice Address - Phone:781-246-0305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1045231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist