Healthcare Provider Details

I. General information

NPI: 1306689831
Provider Name (Legal Business Name): PAIGE ELIZABETH DRAYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 GENOA BUSINESS PARK DR
BRIGHTON MI
48114-5328
US

IV. Provider business mailing address

5755 N BURKHART RD
HOWELL MI
48855-8618
US

V. Phone/Fax

Practice location:
  • Phone: 517-882-3732
  • Fax:
Mailing address:
  • Phone: 517-294-8839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851118089
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: