Provider Demographics
NPI:1184465536
Name:PEAVY, SYDNEY ANNE (OTR/L, CLT)
Entity type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:ANNE
Last Name:PEAVY
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3500
Mailing Address - Country:US
Mailing Address - Phone:336-710-0456
Mailing Address - Fax:
Practice Address - Street 1:190 BROADWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2501
Practice Address - Country:US
Practice Address - Phone:828-412-0908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist