Provider Demographics
NPI:1114618261
Name:THOMPSON, PAIGE (MFT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 NOLAN DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8900
Mailing Address - Country:US
Mailing Address - Phone:612-802-3799
Mailing Address - Fax:
Practice Address - Street 1:1818 RITTENHOUSE SQ
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5837
Practice Address - Country:US
Practice Address - Phone:267-314-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist