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General NPI Number Information
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NPI Number | 1730617754
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Entity Type | Individual
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Provider Name | MAUREEN PAIGE-BOBO LSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4614 PROSPECT AVE STE 325
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City | CLEVELAND
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State | OH
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Zip | 44103-4377
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Country | US
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Telephone | 216-777-2136
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Fax | 888-380-3849
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Provider Business Mailing Address
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Address Line | 4614 PROSPECT AVE STE 325
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City | CLEVELAND
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State | OH
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Zip | 44103-4377
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Country | US
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Telephone | 216-777-2136
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Fax | 888-380-3849
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | S0016468
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License Number State | OH
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