Provider Demographics
NPI:1497566368
Name:PINILLA, PAOLA
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:PINILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 COTTAGE ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-2244
Mailing Address - Country:US
Mailing Address - Phone:786-223-0128
Mailing Address - Fax:
Practice Address - Street 1:119 COTTAGE ST APT 3F
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2244
Practice Address - Country:US
Practice Address - Phone:786-223-0128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14488015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist