Provider Demographics
NPI:1316693146
Name:PAGE, ALANA (LCAT)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 JAY STREET
Mailing Address - Street 2:BLDG J, SUITE 202
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611
Mailing Address - Country:US
Mailing Address - Phone:585-328-0834
Mailing Address - Fax:585-436-0103
Practice Address - Street 1:1099 JAY STREET
Practice Address - Street 2:BLDG J, SUITE 202
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611
Practice Address - Country:US
Practice Address - Phone:585-328-0834
Practice Address - Fax:585-436-0103
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002229221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist