Provider Demographics
NPI:1013561844
Name:BEHR, PETER HOWELL III (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:HOWELL
Last Name:BEHR
Suffix:III
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 TAMALPAIS RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:CA
Mailing Address - Zip Code:94930-1521
Mailing Address - Country:US
Mailing Address - Phone:415-505-2477
Mailing Address - Fax:
Practice Address - Street 1:234 N SAN PEDRO RD
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2858
Practice Address - Country:US
Practice Address - Phone:415-479-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20428225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist