Provider Demographics
NPI:1134418361
Name:GELINEAU, PAULA R (CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:R
Last Name:GELINEAU
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:WEBBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1327 KALAKAKET ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4917
Mailing Address - Country:US
Mailing Address - Phone:907-452-4517
Mailing Address - Fax:907-452-4263
Practice Address - Street 1:1327 KALAKAKET ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4917
Practice Address - Country:US
Practice Address - Phone:907-452-4517
Practice Address - Fax:907-452-4263
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist