MEDICARE: MRS. SOFYA Y BORODOVSKY-LYALIN CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP004291	GA

General Provider Information

NPI Number	:	1942166467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SOFYA Y BORODOVSKY-LYALIN CCC-SLP

Provider Business Mailing Address
First Line	:	4567 LAKE VILLAGE DR
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-5748
Country	:	US
Telephone Number	:	404-667-9230
Fax Number	:

Provider Business Practice Location Address
First Line	:	4567 LAKE VILLAGE DR
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-5748
Country	:	US
Telephone Number	:	404-667-9230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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Directions to “ MRS. SOFYA Y BORODOVSKY-LYALIN CCC-SLP” Practice Location

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