Provider Demographics
NPI:1174200794
Name:MORALES, PAIGE MAREE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:MAREE
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:106 HOHOKAM
Mailing Address - Street 2:
Mailing Address - City:MORENCI
Mailing Address - State:AZ
Mailing Address - Zip Code:85540-9610
Mailing Address - Country:US
Mailing Address - Phone:928-792-8006
Mailing Address - Fax:
Practice Address - Street 1:435 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2157
Practice Address - Country:US
Practice Address - Phone:602-298-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program