Provider Demographics
NPI:1598200305
Name:HAILS, PAIGE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:
Last Name:HAILS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19212
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-9212
Mailing Address - Country:US
Mailing Address - Phone:561-541-6023
Mailing Address - Fax:
Practice Address - Street 1:6212 FOREST HILL BLVD
Practice Address - Street 2:105
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-6145
Practice Address - Country:US
Practice Address - Phone:561-541-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT--16-26303247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other