Provider Demographics
NPI:1396878542
Name:PAGE, ROBERT LESLIE (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LESLIE
Last Name:PAGE
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5427
Mailing Address - Country:US
Mailing Address - Phone:704-258-4556
Mailing Address - Fax:
Practice Address - Street 1:113 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5427
Practice Address - Country:US
Practice Address - Phone:704-258-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health