Provider Demographics
NPI:1982796595
Name:RUBE RAINIER, JEAN (MED, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:RUBE RAINIER
Suffix:
Gender:F
Credentials:MED, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2934
Mailing Address - Country:US
Mailing Address - Phone:603-225-0800
Mailing Address - Fax:
Practice Address - Street 1:170 WARREN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2942
Practice Address - Country:US
Practice Address - Phone:603-225-0800
Practice Address - Fax:603-547-3571
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30400663Medicaid