Provider Demographics
NPI:1609584333
Name:CHEN, PAIGE ALANA (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ALANA
Last Name:CHEN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2359
Mailing Address - Country:US
Mailing Address - Phone:860-313-0179
Mailing Address - Fax:
Practice Address - Street 1:2213 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2210
Practice Address - Country:US
Practice Address - Phone:860-430-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1540103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst