Individual
THERESA LOLISCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
160 HARRISHOF ST, BOSTON, MA 02119-1313
(617) 625-8909
Mailing address
160 HARRISHOF ST, BOSTON, MA 02119-1313
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
024175
NY
235Z00000X
Speech-Language Pathologist
Primary
8975
MA
Other
Enumeration date
04/19/2017
Last updated
03/17/2018
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