Provider Demographics
NPI:1396230991
Name:LOVE-PAIGE, ANDREA LATOYA
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LATOYA
Last Name:LOVE-PAIGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N NELLIS BLVD # A3-141
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5364
Mailing Address - Country:US
Mailing Address - Phone:702-947-4451
Mailing Address - Fax:
Practice Address - Street 1:420 N NELLIS BLVD # A3-141
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5364
Practice Address - Country:US
Practice Address - Phone:702-947-4451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator