Individual
ALLA BOURLATSKII
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
(203) 365-6443
Mailing address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004954
CT
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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