Basic Information
Provider Information
NPI: 1336517994
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUHTA
FirstName: PAIGE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCOTT
OtherFirstName: PAIGE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: OT
OtherLastNameType: 1
Mailing Information
Address1: 33900 HARPER AVE STE 104
Address2:  
City: CLINTON TWP
State: MI
PostalCode: 480354258
CountryCode: US
TelephoneNumber: 5863502644
FaxNumber: 5865413735
Practice Location
Address1: 30100 TELEGRAPH RD STE 140
Address2:  
City: BINGHAM FARMS
State: MI
PostalCode: 48025
CountryCode: US
TelephoneNumber: 2483850030
FaxNumber: 2488499980
Other Information
ProviderEnumerationDate: 09/11/2015
LastUpdateDate: 10/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X5201009247MIY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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