Provider Demographics
NPI:1710709159
Name:LOVETT, PAIGE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:LOVETT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 MILLER DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-3730
Mailing Address - Country:US
Mailing Address - Phone:574-323-3360
Mailing Address - Fax:
Practice Address - Street 1:2102 MILLER DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-3730
Practice Address - Country:US
Practice Address - Phone:574-323-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101009052235Z00000X
IN22007396A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist