Provider Demographics
NPI:1003648593
Name:STOLLE, PEYTON (OTR/L)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:STOLLE
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 1:124 N CALIFORNIA ST UNIT 12
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6987
Mailing Address - Country:US
Mailing Address - Phone:605-310-3201
Mailing Address - Fax:
Practice Address - Street 1:1830 S ALMA SCHOOL RD STE 122
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3087
Practice Address - Country:US
Practice Address - Phone:480-855-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics