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General NPI Number Information
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NPI Number | 1013340397
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Entity Type | Individual
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Provider Name | PAIGE NANTZ JOHNSTON M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 723 S CHARLES ST STE 103
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City | BALTIMORE
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State | MD
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Zip | 21230-3857
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Country | US
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Telephone | 443-622-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 WOODBINE RD
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City | WOODBINE
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State | MD
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Zip | 21797-8221
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Country | US
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Telephone | 443-622-8555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC1001
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License Number State | MD
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