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General NPI Number Information
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NPI Number | 1518581040
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Entity Type | Individual
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Provider Name | MATTY PAGE HAIGHT
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Gender | Female
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 16400 ALDEN AVE
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City | GAITHERSBURG
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State | MD
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Zip | 20877-1508
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Country | US
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Telephone | 240-620-5935
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Fax |
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Provider Business Mailing Address
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Address Line | 761 223RD ST
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City | PASADENA
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State | MD
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Zip | 21122-1337
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Country | US
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Telephone | 904-814-9397
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP10218
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC13088
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License Number State |
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