Provider Demographics
NPI:1699315069
Name:KOLCHARNO, PAIGE MARIE (MA)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:MARIE
Last Name:KOLCHARNO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:PAIGE
Other - Middle Name:MARIE
Other - Last Name:GOLOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2805 CLARENDON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-3314
Mailing Address - Country:US
Mailing Address - Phone:570-561-8897
Mailing Address - Fax:
Practice Address - Street 1:10 BOULDER CRESCENT ST STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3350
Practice Address - Country:US
Practice Address - Phone:719-633-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist