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General NPI Number Information
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NPI Number | 1497547681
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Entity Type | Individual
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Provider Name | JENNIFER M PAIGE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 5118 PARK AVE
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City | MEMPHIS
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State | TN
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Zip | 38117-5720
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Country | US
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Telephone | 901-528-9863
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SHELLEY RENEE LN
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City | CORDOVA
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State | TN
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Zip | 38018-7373
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Country | US
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Telephone | 256-453-5383
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Fax | 256-453-5383
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2419
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License Number State | AL
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