MEDICARE: MADISON PAIGE LYTTLE OTD

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	225X00000X	Occupational Therapist	OT013199	OH

General Provider Information

NPI Number	:	1952108995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON PAIGE LYTTLE OTD

Provider Business Mailing Address
First Line	:	4295 DROWFIELD DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45426-1915
Country	:	US
Telephone Number	:	513-609-7933
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 CLAY ST
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-2102
Country	:	US
Telephone Number	:	513-609-7933
Fax Number	:

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

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	03/02/2026

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