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NPI Code Detail

MEDICARE: PAIGE NEDROW

MEDICARE: PAIGE NEDROW
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1538936919
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE NEDROW
Provider Business Mailing Address
First Line : 145 ADAM LN
Second Line :
City : COLUMBIA
State : IL
Zip : 62236-4372
Country : US
Telephone Number : 618-381-0135
Fax Number :
Provider Business Practice Location Address
First Line : 411 EDWARDSVILLE RD
Second Line :
City : TROY
State : IL
Zip : 62294-1339
Country : US
Telephone Number : 314-275-0506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2023
Last Update Date : 12/06/2023

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Directions to “ PAIGE NEDROW ” Practice Location

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