Provider Demographics
NPI:1801354162
Name:PAGE, ANNELISE CLAIRE (MS, MA, LGC)
Entity type:Individual
Prefix:MS
First Name:ANNELISE
Middle Name:CLAIRE
Last Name:PAGE
Suffix:
Gender:F
Credentials:MS, MA, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10494 MONTGOMERY RD RM 2102
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5214
Mailing Address - Country:US
Mailing Address - Phone:513-865-5926
Mailing Address - Fax:513-852-8918
Practice Address - Street 1:10494 MONTGOMERY RD RM 2102
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5214
Practice Address - Country:US
Practice Address - Phone:513-865-5926
Practice Address - Fax:513-852-8918
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000410TEMP170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS