MEDICARE: RANDE PAIGE

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1689964850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDE PAIGE

Provider Business Mailing Address
First Line	:	911 N BUFFALO DR
Second Line	:	SUITE 213
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0381
Country	:	US
Telephone Number	:	702-942-1774
Fax Number	:	702-942-1773

Provider Business Practice Location Address
First Line	:	911 N BUFFALO DR
Second Line	:	SUITE 213
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0381
Country	:	US
Telephone Number	:	702-942-1774
Fax Number	:	702-942-1773

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	10/26/2012

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Directions to “ RANDE PAIGE ” Practice Location

Language	Start Address	Practice Location

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