Provider Demographics
NPI:1023325776
Name:PEYTON, GINA EICH (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:EICH
Last Name:PEYTON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6940
Mailing Address - Country:US
Mailing Address - Phone:219-462-0786
Mailing Address - Fax:
Practice Address - Street 1:2801 EVANS AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6940
Practice Address - Country:US
Practice Address - Phone:219-462-0786
Practice Address - Fax:219-548-7543
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004948A225X00000X
IL056.009029225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist