Healthcare Provider Details

I. General information

NPI: 1487951380
Provider Name (Legal Business Name): LISA AKSU M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2011
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARK DR
WESTFORD MA
01886-3511
US

IV. Provider business mailing address

6B LILAC CIR
GROTON MA
01450-1171
US

V. Phone/Fax

Practice location:
  • Phone: 978-392-1144
  • Fax:
Mailing address:
  • Phone: 413-504-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8188
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: