Individual
MYRA CHANTEL PAIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-6429
(228) 497-0690
(228) 497-1363
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-6429
(228) 497-0690
(228) 497-1363
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
05/04/2011
Last updated
05/09/2011
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