Provider Demographics
NPI:1922561638
Name:MENOLASCINO, PAIGE LAUREN (OTD, OTR-L)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:LAUREN
Last Name:MENOLASCINO
Suffix:
Gender:F
Credentials:OTD, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9316 OAK ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2802
Mailing Address - Country:US
Mailing Address - Phone:402-957-3170
Mailing Address - Fax:
Practice Address - Street 1:600 BROOKSTONE MEADOWS PLZ
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4401
Practice Address - Country:US
Practice Address - Phone:402-289-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2282225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation