Provider Demographics
NPI:1780029934
Name:KOHILAKIS, ROXANNE (AUD)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:KOHILAKIS
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 DIXWELL AVE STE B-3
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3130
Mailing Address - Country:US
Mailing Address - Phone:203-675-5455
Mailing Address - Fax:
Practice Address - Street 1:2911 DIXWELL AVE STE B-3
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3130
Practice Address - Country:US
Practice Address - Phone:203-479-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000549231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist