Provider Demographics
NPI:1740202639
Name:VALES, PAULINA A (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PAULINA
Middle Name:A
Last Name:VALES
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7045 CARRIAGE HILL DR
Mailing Address - Street 2:# 203
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1269
Mailing Address - Country:US
Mailing Address - Phone:216-334-5008
Mailing Address - Fax:440-746-0096
Practice Address - Street 1:7045 CARRIAGE HILL DR
Practice Address - Street 2:# 203
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1269
Practice Address - Country:US
Practice Address - Phone:216-334-5008
Practice Address - Fax:440-746-0096
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP6413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist