Provider Demographics
NPI:1053146324
Name:EDWARDS, PAIGE DOREEN (BS, CSWA)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:DOREEN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:BS, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1522
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1522
Mailing Address - Country:US
Mailing Address - Phone:925-286-1748
Mailing Address - Fax:
Practice Address - Street 1:760 NW HARRIMAN ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2789
Practice Address - Country:US
Practice Address - Phone:541-316-0266
Practice Address - Fax:541-229-1302
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA155771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical