Provider Demographics
NPI:1689492902
Name:MULCAHY, PAIGE ALEXIS
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ALEXIS
Last Name:MULCAHY
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 1:2025 ATKINS AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-5444
Mailing Address - Country:US
Mailing Address - Phone:216-789-9038
Mailing Address - Fax:
Practice Address - Street 1:1750 E 234TH ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1913
Practice Address - Country:US
Practice Address - Phone:216-797-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20242711-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist