Provider Demographics
NPI:1497594303
Name:BLACK, PAIGE EMILY (MMSC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:EMILY
Last Name:BLACK
Suffix:
Gender:F
Credentials:MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON ROAD
Mailing Address - Street 2:CLINIC B, SUITE 2200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-8570
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON ROAD
Practice Address - Street 2:CLINIC B, SUITE 2200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-8570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS