Provider Demographics
NPI:1770318396
Name:GOEZ IRVING, PAIGE ELIZABETH (BA)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:GOEZ IRVING
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:PAIGE
Other - Middle Name:ELIZABETH
Other - Last Name:IRVING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA
Mailing Address - Street 1:21 REVERE BEACH BLVD APT 621R
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3774
Mailing Address - Country:US
Mailing Address - Phone:603-520-9901
Mailing Address - Fax:
Practice Address - Street 1:21 REVERE BEACH BLVD APT 621R
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3774
Practice Address - Country:US
Practice Address - Phone:603-520-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health