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NPI Code Detail

MEDICARE: DR. TINA LEPAGE PSY.D.

MEDICARE:  DR. TINA  LEPAGE  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2865NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508089251
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TINA LEPAGE PSY.D.
Provider Business Mailing Address
First Line : 1703 LEGION RD
Second Line : SUITE 204
City : CHAPEL HILL
State : NC
Zip : 27517-2359
Country : US
Telephone Number : 919-933-5355
Fax Number : 919-929-3227
Provider Business Practice Location Address
First Line : 1703 LEGION RD
Second Line : SUITE 204
City : CHAPEL HILL
State : NC
Zip : 27517-2359
Country : US
Telephone Number : 919-933-5355
Fax Number : 919-929-3227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/09/2007

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