Provider Demographics
NPI:1720786072
Name:DUDEK, PAIGE REESE (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:REESE
Last Name:DUDEK
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:NICOLE
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:69 EASTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-0917
Mailing Address - Country:US
Mailing Address - Phone:724-984-7413
Mailing Address - Fax:
Practice Address - Street 1:130 KAUFMAN DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2179
Practice Address - Country:US
Practice Address - Phone:304-363-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist