MEDICARE: MS. STEPHANIE PAIGE MOYER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XG0600X	Gerontology Occupational Therapist

General Provider Information

NPI Number	:	1629339288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE PAIGE MOYER

Provider Business Mailing Address
First Line	:	308 E RAILROAD AVE
Second Line	:
City	:	OKAWVILLE
State	:	IL
Zip	:	62271-2224
Country	:	US
Telephone Number	:	618-791-2045
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 ANNABLE CT
Second Line	:
City	:	CAHOKIA
State	:	IL
Zip	:	62206-2204
Country	:	US
Telephone Number	:	618-332-0114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	10/22/2025

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