Provider Demographics
NPI:1316396740
Name:PLOTKIN, PAIGE ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:PLOTKIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 REEVES ST
Mailing Address - Street 2:APT# 111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2900
Mailing Address - Country:US
Mailing Address - Phone:609-287-0283
Mailing Address - Fax:
Practice Address - Street 1:1445 REEVES ST
Practice Address - Street 2:APT# 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2900
Practice Address - Country:US
Practice Address - Phone:609-287-0283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 23808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist