=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033029392
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LESLIE FAIR-PAGE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2026
-----------------------------------------------------
Last Update Date | 09/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 306 HIGHLAND AVE
-----------------------------------------------------
City | WASHINGTON COURT HOUSE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43160-1819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-335-6620
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2987 TORRINGTON RD
-----------------------------------------------------
City | SHAKER HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-2557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-213-8816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | OH3478338
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------