Individual
MRS. YELENA MAMEDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC/SLP
Contact information
Practice address
13 CLARK ST, UNIT 2, WALTHAM, MA 02453-6012
(617) 733-4378
Mailing address
13 CLARK ST, UNIT 2, WALTHAM, MA 02453-6012
(617) 733-4378
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5476
MA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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