Provider Demographics
NPI:1770661621
Name:PEEPLES, BLAIR L (OT)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:L
Last Name:PEEPLES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BISHOP GADSDEN WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3506
Mailing Address - Country:US
Mailing Address - Phone:843-406-6302
Mailing Address - Fax:843-406-6540
Practice Address - Street 1:1 BISHOP GADSDEN WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3506
Practice Address - Country:US
Practice Address - Phone:843-406-6302
Practice Address - Fax:843-406-6540
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist