MEDICARE: DR. PAULA CAROLE RABIDOUX PHD/CCC

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	SP-2101	OH

General Provider Information

NPI Number	:	1336169556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA CAROLE RABIDOUX PHD/CCC

Provider Business Mailing Address
First Line	:	1581 DODD DR
Second Line	:	323 MCCAMPBELL
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1257
Country	:	US
Telephone Number	:	614-688-8472
Fax Number	:	614-247-6073

Provider Business Practice Location Address
First Line	:	1581 DODD DR
Second Line	:	323 MCCAMPBELL
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1257
Country	:	US
Telephone Number	:	614-688-8472
Fax Number	:	614-247-6073

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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