Provider Demographics
NPI:1134845001
Name:ROCKHOLD, PAIGE NICHOLLE (OTR/L)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICHOLLE
Last Name:ROCKHOLD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:NICHOLLE
Other - Last Name:KLEKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1552 COUNTRY CLUB PLAZA DR UNIT 1570
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3859
Mailing Address - Country:US
Mailing Address - Phone:636-724-1127
Mailing Address - Fax:636-724-1671
Practice Address - Street 1:1552 COUNTRY CLUB PLAZA DR UNIT 1570
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3859
Practice Address - Country:US
Practice Address - Phone:636-724-1127
Practice Address - Fax:636-724-1671
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014031545225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist