Provider Demographics
NPI:1689683559
Name:PAIGE, HEATHER RENEE (PSYD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RENEE
Last Name:PAIGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21224 STEPTOE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20117-3138
Mailing Address - Country:US
Mailing Address - Phone:540-687-5647
Mailing Address - Fax:
Practice Address - Street 1:108 WEST WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20118
Practice Address - Country:US
Practice Address - Phone:703-801-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT177074OtherBCBS
G3960043OtherBCBSNATIONAL CAPTIAL AREA
VT177074OtherBCBS