Provider Demographics
NPI:1689214298
Name:RECKNER, PAIGE ASHLEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ASHLEY
Last Name:RECKNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:ASHLEY
Other - Last Name:PORTALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7156 BILLY GOAT DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3872 ATTUCKS DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6164
Practice Address - Country:US
Practice Address - Phone:614-588-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist