Provider Demographics
NPI:1356898498
Name:FREY, PAIGE NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICOLE
Last Name:FREY
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 1:914 CHARLEVOIX DR STE 150
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-2294
Mailing Address - Country:US
Mailing Address - Phone:517-627-9292
Mailing Address - Fax:
Practice Address - Street 1:914 CHARLEVOIX DR STE 150
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-2294
Practice Address - Country:US
Practice Address - Phone:517-627-9292
Practice Address - Fax:517-627-9291
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009580225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist