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NPI Code Detail

MEDICARE: PAIGE OLIVIA MCCOLLUM M.S., CF-SLP

MEDICARE: PAIGE OLIVIA MCCOLLUM M.S., CF-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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1306456561
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE OLIVIA MCCOLLUM M.S., CF-SLP
Provider Business Mailing Address
First Line : 12717 CAPELLA TRL
Second Line :
City : AUSTIN
State : TX
Zip : 78732-2396
Country : US
Telephone Number : 816-885-2687
Fax Number :
Provider Business Practice Location Address
First Line : 1310 W SLAUGHTER LN
Second Line :
City : AUSTIN
State : TX
Zip : 78748-6556
Country : US
Telephone Number : 888-308-3728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2020
Last Update Date : 08/13/2020

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Directions to “ PAIGE OLIVIA MCCOLLUM M.S., CF-SLP” Practice Location

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