Individual
ATHANASIOS VARDOULIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP, TSSLD
Contact information
Practice address
73 CENTRAL ST APT 3, WALTHAM, MA 02453-5446
(516) 603-1262
Mailing address
73 CENTRAL ST APT 3, WALTHAM, MA 02453-5446
(516) 603-1262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
019880
NY
235Z00000X
Speech-Language Pathologist
Primary
9044
MA
Other
Enumeration date
04/09/2013
Last updated
10/09/2015
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