Provider Demographics
NPI:1629339288
Name:MOYER, STEPHANIE PAIGE
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:PAIGE
Last Name:MOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:OKAWVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62271-2224
Mailing Address - Country:US
Mailing Address - Phone:618-791-2045
Mailing Address - Fax:
Practice Address - Street 1:2 ANNABLE CT
Practice Address - Street 2:
Practice Address - City:CAHOKIA
Practice Address - State:IL
Practice Address - Zip Code:62206-2204
Practice Address - Country:US
Practice Address - Phone:618-332-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology