Provider Demographics
NPI:1578891636
Name:MCPECK, DANIELLE LEIGH (OTD, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LEIGH
Last Name:MCPECK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E CLAY ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45338-8043
Mailing Address - Country:US
Mailing Address - Phone:937-962-2165
Mailing Address - Fax:
Practice Address - Street 1:1600 PARK AVE
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-8678
Practice Address - Country:US
Practice Address - Phone:937-456-3010
Practice Address - Fax:937-456-7199
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007142225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist