Provider Demographics
NPI:1538676978
Name:MANION, PAIGE ELIZABETH
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:MANION
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 1:9351 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5437
Mailing Address - Country:US
Mailing Address - Phone:804-596-3275
Mailing Address - Fax:
Practice Address - Street 1:14321 WINTER BREEZE DR STE 91
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2452
Practice Address - Country:US
Practice Address - Phone:980-785-1113
Practice Address - Fax:980-785-1114
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-15-06128106S00000X
VA0133001151103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician