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General NPI Number Information
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NPI Number | 1356013411
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Entity Type | Individual
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Provider Name | PAIGE RAINES CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 109 BLOSSOM LN
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City | SALEM
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State | OH
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Zip | 44460-4284
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Country | US
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Telephone | 724-988-9850
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 BOULDER LN APT 204
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City | KENT
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State | OH
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Zip | 44240-8238
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Country | US
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Telephone |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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