Provider Demographics
NPI:1356641245
Name:PEAKE, VICTORIA FAR (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:FAR
Last Name:PEAKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:BRUCE
Other - Last Name:FAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:12 RICKER TERRACE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458
Mailing Address - Country:US
Mailing Address - Phone:203-240-7069
Mailing Address - Fax:
Practice Address - Street 1:12 RICKER TERRACE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458
Practice Address - Country:US
Practice Address - Phone:617-355-6588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10148225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist