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General NPI Number Information
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NPI Number | 1679634430
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Entity Type | Individual
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Provider Name | PAIGE BRADLEY EPPLEY MA LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 5987 SNOWY EGRET DR
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City | SARASOTA
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State | FL
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Zip | 34238-3760
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Country | US
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Telephone | 941-224-3464
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Fax | 941-922-6604
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Provider Business Mailing Address
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Address Line | 5987 SNOWY EGRET DR
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City | SARASOTA
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State | FL
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Zip | 34238-3760
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Country | US
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Telephone | 941-224-3464
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Fax | 941-922-6604
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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 | MH5614
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License Number State | FL
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