Provider Demographics
NPI:1700601432
Name:SAVAGE, PAIGE (MED, BCBA)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11448 LAKERIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2458
Mailing Address - Country:US
Mailing Address - Phone:405-501-2377
Mailing Address - Fax:
Practice Address - Street 1:401 S COLTRANE RD STE 260
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6722
Practice Address - Country:US
Practice Address - Phone:405-501-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-24-76612103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst