Individual
PAIGE A LEAVITT-HALSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 CHARLES ELDRIDGE DRIVE, TRANQUIL MIND & WELLNESS INC, LAKEVILLE, MA 02347
(508) 947-1683
(508) 947-1684
Mailing address
104 CHARLES ELDRIDGE DRIVE, LAKEVILLE, MA 02347
(508) 947-1683
(508) 947-1684
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
APRN175441
MA
364S00000X
Clinical Nurse Specialist
APRN175441
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1895028
MBHP
—
01
—
2173937
CIGNA
—
01
—
271408
BLUE CROSS
RI
01
—
33106235303
PACIFICARE
—
01
—
469386
TUFTS
—
01
—
PN0805
BLUE CROSS
MA
Enumeration date
07/29/2006
Last updated
02/17/2011
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