Provider Demographics
NPI:1932470911
Name:PEAK, ABBY SUZANNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:SUZANNE
Last Name:PEAK
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 1:645 KNOX BLVD
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-1514
Mailing Address - Country:US
Mailing Address - Phone:270-351-2224
Mailing Address - Fax:
Practice Address - Street 1:645 KNOX BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1514
Practice Address - Country:US
Practice Address - Phone:270-351-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2823225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist