Provider Demographics
NPI:1962626747
Name:PAIGE, KATHI
Entity Type:Individual
Prefix:
First Name:KATHI
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 1:176 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1150
Mailing Address - Country:US
Mailing Address - Phone:781-871-6360
Mailing Address - Fax:
Practice Address - Street 1:36 N BEDFORD ST
Practice Address - Street 2:
Practice Address - City:E BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1186
Practice Address - Country:US
Practice Address - Phone:508-378-9000
Practice Address - Fax:781-878-8645
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical