| Organization Name: | PROVIDENCE VA MEDICAL CENTER |
| NPI Number: | 1174633598 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | INESA VINARSKAYA (SPEECH-LANGUAGE PATHOLOGIST) |
| Mailing Address: | 830 Chalkstone Ave Providence |
| State: | RI US |
| Postal Code: | 029084734 |
| Phone Number: | 4012737100 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP00595 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |