Provider Demographics
NPI:1841415973
Name:DILLON-PAGE, TANYA LOUISE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:LOUISE
Last Name:DILLON-PAGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-2712
Mailing Address - Country:US
Mailing Address - Phone:304-727-6604
Mailing Address - Fax:
Practice Address - Street 1:2157 GREENBRIER ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-9623
Practice Address - Country:US
Practice Address - Phone:304-344-5924
Practice Address - Fax:304-344-1005
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional