Provider Demographics
NPI:1922792100
Name:VAIA, NIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NIA
Middle Name:
Last Name:VAIA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10370 HALIGUS RD STE 203
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9582
Mailing Address - Country:US
Mailing Address - Phone:847-802-7050
Mailing Address - Fax:847-515-8832
Practice Address - Street 1:10370 HALIGUS RD STE 203
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9582
Practice Address - Country:US
Practice Address - Phone:847-802-7050
Practice Address - Fax:847-515-8832
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.017907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist