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General NPI Number Information
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NPI Number | 1114298197
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Entity Type | Individual
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Provider Name | RACHEL LAGO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 2180 SCHOOL DR
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City | STATE COLLEGE
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State | PA
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Zip | 16803-1130
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Country | US
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Telephone | 814-272-3994
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 W WHITEHALL RD
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City | PENNSYLVANIA FURNACE
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State | PA
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Zip | 16865-9557
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Country | US
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Telephone | 814-404-1937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | PA
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