Provider Demographics
NPI:1922318765
Name:PEAVEY, DELBERT L JR (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DELBERT
Middle Name:L
Last Name:PEAVEY
Suffix:JR
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 1:36 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04071-6164
Mailing Address - Country:US
Mailing Address - Phone:207-655-2648
Mailing Address - Fax:
Practice Address - Street 1:110 FARWELL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-4822
Practice Address - Country:US
Practice Address - Phone:207-795-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist