Provider Demographics
NPI:1801379037
Name:CROSBY, PAIGE ELISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELISE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 ALBION AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-3302
Mailing Address - Country:US
Mailing Address - Phone:877-646-4742
Mailing Address - Fax:507-399-2153
Practice Address - Street 1:2423 ALBION AVE STE 5
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3302
Practice Address - Country:US
Practice Address - Phone:877-646-4742
Practice Address - Fax:507-399-2153
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090734225X00000X
MN105508225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist