Provider Demographics
NPI:1083862726
Name:SUARES, PAIGE BAILEY (SLP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:BAILEY
Last Name:SUARES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CRITTENDEN ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-6329
Mailing Address - Country:US
Mailing Address - Phone:662-402-8765
Mailing Address - Fax:
Practice Address - Street 1:304 CRITTENDEN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-6329
Practice Address - Country:US
Practice Address - Phone:662-402-8765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-06
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2849235Z00000X
MSS2089235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist