Healthcare Provider Details

I. General information

NPI: 1033029392
Provider Name (Legal Business Name): LESLIE FAIR-PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 HIGHLAND AVE
WASHINGTON COURT HOUSE OH
43160-1819
US

IV. Provider business mailing address

2987 TORRINGTON RD
SHAKER HEIGHTS OH
44122-2557
US

V. Phone/Fax

Practice location:
  • Phone: 740-335-6620
  • Fax:
Mailing address:
  • Phone: 917-213-8816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3478338
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: