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General NPI Number Information
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NPI Number | 1649917030
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Entity Type | Individual
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Provider Name | PAIGE ELIZABETH WING MED LPC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 350 PINE ST STE 760
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City | BEAUMONT
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State | TX
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Zip | 77701-2421
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Country | US
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Telephone | 409-223-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 157 WINDSOR CIR
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City | LUMBERTON
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State | TX
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Zip | 77657-7167
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Country | US
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Telephone | 409-658-1237
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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 | 82955
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License Number State | TX
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