Provider Demographics
NPI:1760089056
Name:ELLIOTT, PAIGE TAYLOR
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:TAYLOR
Last Name:ELLIOTT
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 1:1012 GOLDEN PARK PL APT D
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2442
Mailing Address - Country:US
Mailing Address - Phone:510-207-4237
Mailing Address - Fax:
Practice Address - Street 1:11011 W 6TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5596
Practice Address - Country:US
Practice Address - Phone:720-497-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic