Provider Demographics
NPI:1689964850
Name:PAIGE, RANDE
Entity Type:Individual
Prefix:
First Name:RANDE
Middle Name:
Last Name:PAIGE
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 1:911 N BUFFALO DR
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0381
Mailing Address - Country:US
Mailing Address - Phone:702-942-1774
Mailing Address - Fax:702-942-1773
Practice Address - Street 1:911 N BUFFALO DR
Practice Address - Street 2:SUITE 213
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0381
Practice Address - Country:US
Practice Address - Phone:702-942-1774
Practice Address - Fax:702-942-1773
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst