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Individual

MRS. MARY WILLIS PAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA LPA

Contact information

Practice address
165 MAHALEY AVE, SALISBURY, NC 28144-2448
(704) 213-1099
(704) 919-5381
Mailing address
165 MAHALEY AVE, SALISBURY, NC 28144-2448
(704) 213-1099
(704) 919-5381

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1246
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046G7
NC BCBS
NC
05
6107050
NC
Enumeration date
06/08/2006
Last updated
03/21/2021
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