Healthcare Provider Details

I. General information

NPI: 1780528083
Provider Name (Legal Business Name): AMANDA CIULLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 GREAT RD
STOW MA
01775-1190
US

IV. Provider business mailing address

23 TALLARD RD
WESTFORD MA
01886-4011
US

V. Phone/Fax

Practice location:
  • Phone: 732-829-9030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPSLP10170
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: