Provider Demographics
NPI:1861972937
Name:NEWMAN, ALAINA PAIGE (COTA)
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:PAIGE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ROSEBROOK ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654-3726
Mailing Address - Country:US
Mailing Address - Phone:903-722-3974
Mailing Address - Fax:
Practice Address - Street 1:810 BELLAIRE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-9045
Practice Address - Country:US
Practice Address - Phone:903-589-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215208224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist