Healthcare Provider Details

I. General information

NPI: 1659275683
Provider Name (Legal Business Name): PAIGE MCINTIRE OTD, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10100 LANTERN RD
FISHERS IN
46037-9651
US

IV. Provider business mailing address

8130 PAINTED PONY DR
INDIANAPOLIS IN
46217-9018
US

V. Phone/Fax

Practice location:
  • Phone: 317-720-3478
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31007547A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: