Healthcare Provider Details

I. General information

NPI: 1306523675
Provider Name (Legal Business Name): PAIGE ELIZABETH KAHLECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SHERMAN ST STE 390
SAINT PAUL MN
55102-2564
US

IV. Provider business mailing address

360 SHERMAN ST STE 390
SAINT PAUL MN
55102-2564
US

V. Phone/Fax

Practice location:
  • Phone: 952-270-5605
  • Fax:
Mailing address:
  • Phone: 952-270-5605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: