Provider Demographics
NPI:1275728032
Name:RASMUSSEN, MAIDA CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:MAIDA
Middle Name:CHRISTINE
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAIDA
Other - Middle Name:CHRISTINE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3054 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2755
Mailing Address - Country:US
Mailing Address - Phone:814-321-4340
Mailing Address - Fax:
Practice Address - Street 1:3054 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2755
Practice Address - Country:US
Practice Address - Phone:814-234-6023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008918235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist