Individual
VISNAVY VICKNESWARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
49 HILL ST, MALDEN, MA 02148-1639
(781) 350-8033
Mailing address
49 HILL ST, MALDEN, MA 02148-1639
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP100676
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP100676
BOARD OF REGISTRATION FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
MA
Enumeration date
05/04/2026
Last updated
05/04/2026
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