Provider Demographics
NPI:1932509718
Name:PEELER, ANNA THOMPSON (MOT/L)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:THOMPSON
Last Name:PEELER
Suffix:
Gender:F
Credentials:MOT/L
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:517 TRACE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7311
Mailing Address - Country:US
Mailing Address - Phone:910-599-0534
Mailing Address - Fax:
Practice Address - Street 1:508 NAVIGATOR DR
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443
Practice Address - Country:US
Practice Address - Phone:910-685-4505
Practice Address - Fax:910-939-1519
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1932509718Medicaid