Provider Demographics
NPI:1457196388
Name:LEBAHN, PAIGE NICOLE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICOLE
Last Name:LEBAHN
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:NICOLE
Other - Last Name:BOOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2830 FLETCHER AVE APT 265
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1179
Mailing Address - Country:US
Mailing Address - Phone:605-214-6625
Mailing Address - Fax:
Practice Address - Street 1:2830 FLETCHER AVE APT 265
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-1179
Practice Address - Country:US
Practice Address - Phone:605-214-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2910225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist