Healthcare Provider Details

I. General information

NPI: 1932254315
Provider Name (Legal Business Name): DONALD F PAGE JR. MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S. ATHERTON ST. SUITE 105
STATE COLLEGE PA
16801-7641
US

IV. Provider business mailing address

1402 S. ATHERTON ST. SUITE 105
STATE COLLEGE PA
16801-7641
US

V. Phone/Fax

Practice location:
  • Phone: 814-862-9122
  • Fax:
Mailing address:
  • Phone: 814-862-9122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW125697
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier125697
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: