Provider Demographics
NPI:1386173219
Name:PAIGE, BRIANNA (MED, BCBA, COBA)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:
Last Name:PAIGE
Suffix:
Gender:F
Credentials:MED, BCBA, COBA
Other - Prefix:MS
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA, COBA
Mailing Address - Street 1:5669 LOYOLA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5586
Mailing Address - Country:US
Mailing Address - Phone:513-317-8851
Mailing Address - Fax:
Practice Address - Street 1:70 BIRCH ALY STE 240
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-1477
Practice Address - Country:US
Practice Address - Phone:718-360-9548
Practice Address - Fax:845-510-8333
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOBA.00577103K00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator