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NPI Code Detail

MEDICARE: PAIGE LANDAU PHD

MEDICARE: PAIGE LANDAU PHD
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
1103TC2200XClinical Child & Adolescent Psychologist
2103TC2200XClinical Child & Adolescent Psychologist0006019CO

General Provider Information

NPI Number : 1801404389
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE LANDAU PHD
Provider Business Mailing Address
First Line : 7662 E COSTILLA AVE
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-1207
Country : US
Telephone Number : 484-336-5049
Fax Number :
Provider Business Practice Location Address
First Line : 2170 S PARKER RD STE 290
Second Line :
City : DENVER
State : CO
Zip : 80231-5748
Country : US
Telephone Number : 484-336-5049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2020
Last Update Date : 01/21/2023

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