MEDICARE: MRS. TANYA LOUISE DILLON-PAGE LPC

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	101YP2500X	Professional Counselor	1433	WV

General Provider Information

NPI Number	:	1841415973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANYA LOUISE DILLON-PAGE LPC

Provider Business Mailing Address
First Line	:	7 SHERIDAN DR
Second Line	:
City	:	SAINT ALBANS
State	:	WV
Zip	:	25177-2712
Country	:	US
Telephone Number	:	304-727-6604
Fax Number	:

Provider Business Practice Location Address
First Line	:	2157 GREENBRIER ST
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25311-9623
Country	:	US
Telephone Number	:	304-344-5924
Fax Number	:	304-344-1005

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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