Provider Information for 1063544328
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Mr. PRESTON HENRY PAGE LCSW, LSATP
Sex: Male
NPI: 1063544328
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1063544328 | ||||||||
| Enumeration Date | 2007-03-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 900 F STARLING AVENUE POB 333 MARTINSVILLE, VA 24114 United States Phone: 276-734-9870 | Fax:276-666-2332 | ||||||||
| Primary Practice Address | 900 F STARLING AVENUE POB 333 MARTINSVILLE, VA 24114 United States Phone: 276-734-9870 | Fax:276-666-2332 | ||||||||
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