Provider Demographics
NPI:1346525102
Name:PECK, HANNAH KATE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KATE
Last Name:PECK
Suffix:
Gender:F
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 1:1260 LEHIGH STATION RD
Mailing Address - Street 2:APT. 108
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9243
Mailing Address - Country:US
Mailing Address - Phone:315-317-8252
Mailing Address - Fax:
Practice Address - Street 1:1260 LEHIGH STATION RD
Practice Address - Street 2:APT. 108
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9243
Practice Address - Country:US
Practice Address - Phone:315-317-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016983-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist