Provider Demographics
NPI:1578273785
Name:HARRIMAN, PAIGE DANIELLE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:DANIELLE
Last Name:HARRIMAN
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 1:150 E WILSON BRIDGE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2328
Mailing Address - Country:US
Mailing Address - Phone:614-505-7100
Mailing Address - Fax:
Practice Address - Street 1:150 E WILSON BRIDGE RD STE 130
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2328
Practice Address - Country:US
Practice Address - Phone:614-505-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021551225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist