Provider Demographics
NPI:1609659648
Name:LOCKHART, PAIGE JA NE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:JA NE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 HAVERWOOD LN APT 3415
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4444
Mailing Address - Country:US
Mailing Address - Phone:314-456-4049
Mailing Address - Fax:
Practice Address - Street 1:4911 HAVERWOOD LN APT 3415
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-4444
Practice Address - Country:US
Practice Address - Phone:314-456-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-23-76545103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst