Provider Demographics
NPI:1669952974
Name:BOGGS, PAIGE ELIZABETH (OTR)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:BOGGS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:PAIGE
Other - Middle Name:ELIZABETH
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7350 MERIDIAN HILLS CT APT B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-3485
Mailing Address - Country:US
Mailing Address - Phone:260-237-1031
Mailing Address - Fax:
Practice Address - Street 1:6437 RUCKER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4885
Practice Address - Country:US
Practice Address - Phone:317-405-9016
Practice Address - Fax:888-654-4116
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006716A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist