Provider Demographics
NPI:1124838644
Name:FLANNIGAN, PAOLA
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:FLANNIGAN
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 1:81 SAMARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3922
Mailing Address - Country:US
Mailing Address - Phone:207-576-5035
Mailing Address - Fax:
Practice Address - Street 1:81 SAMARITAN AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3922
Practice Address - Country:US
Practice Address - Phone:207-576-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services