Basic Information
| Provider Information | |||||||||
| NPI: | 1477919819 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARSON | ||||||||
| FirstName: | PAIGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49 WALNUT ST BLDG 3 | ||||||||
| Address2: | |||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024812108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812390100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 49 WALNUT ST BLDG 3 | ||||||||
| Address2: | |||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024812108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543446550 | ||||||||
| FaxNumber: | 9543448634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2016 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.