Provider Demographics
NPI:1285979955
Name:RICHARDSON, ALAINA
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2119
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-2119
Mailing Address - Country:US
Mailing Address - Phone:941-224-6941
Mailing Address - Fax:
Practice Address - Street 1:202 CHARLESTON AVENUE
Practice Address - Street 2:
Practice Address - City:TECOPA
Practice Address - State:CA
Practice Address - Zip Code:92389
Practice Address - Country:US
Practice Address - Phone:941-224-6941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner