Provider Demographics
NPI:1023155157
Name:RAINEY, JEANINE WINDISH (MS CCCSLP)
Entity type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:WINDISH
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:MRS
Other - First Name:JEANINE
Other - Middle Name:M
Other - Last Name:RIORDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCCSLP
Mailing Address - Street 1:9529 COUNTRY CLUB GREEN DR
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-849-4944
Mailing Address - Fax:
Practice Address - Street 1:9529 COUNTRY CLUB GREEN DR
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-849-4944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist