Healthcare Provider Details

I. General information

NPI: 1356931125
Provider Name (Legal Business Name): LEARNING GALLERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1996 CENTRE ST LOWR LEVEL
WEST ROXBURY MA
02132-3329
US

IV. Provider business mailing address

1996 CENTRE ST LOWR LEVEL
WEST ROXBURY MA
02132-3329
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-3591
  • Fax:
Mailing address:
  • Phone: 508-233-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTINA STAVRAKAS
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential:
Phone: 508-233-3591