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General NPI Number Information
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NPI Number | 1023558277
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Entity Type | Individual
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Provider Name | PAIGE KLOBUKA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 7209 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2021
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Country | US
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Telephone | 317-432-4623
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Fax |
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Provider Business Mailing Address
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Address Line | 6108 INDIANOLA AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2016
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Country | US
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Telephone | 317-432-4623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31007746A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.011858
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License Number State | IL
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