Healthcare Provider Details

I. General information

NPI: 1689683559
Provider Name (Legal Business Name): HEATHER RENEE PAIGE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WEST WASHINGTON STREET
MIDDLEBURG VA
20118
US

IV. Provider business mailing address

21224 STEPTOE HILL RD
MIDDLEBURG VA
20117-3138
US

V. Phone/Fax

Practice location:
  • Phone: 703-801-8559
  • Fax:
Mailing address:
  • Phone: 540-687-5647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003066
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: