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General NPI Number Information
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NPI Number | 1114586393
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Entity Type | Organization
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Legal Business Name | PAIGE OUIMETTE, PHD, PSYCHOLOGIST, PC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1101 ERIE BLVD E STE 206
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City | SYRACUSE
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State | NY
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Zip | 13210-1144
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Country | US
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Telephone | 315-436-5825
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Fax | 315-679-4214
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Provider Business Mailing Address
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Address Line | 116 SHIRLEY RD
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City | SYRACUSE
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State | NY
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Zip | 13224-1912
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Country | US
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Telephone | 315-436-5825
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Fax | 315-679-4214
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. PAIGE OUIMETTE
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Credential | PHD
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Telephone | 315-436-5825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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