Provider Demographics
NPI:1508617929
Name:PEPIN, SAVANNAH (OTR/L)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:PEPIN
Suffix:
Gender:
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 1:2557 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4712
Mailing Address - Country:US
Mailing Address - Phone:980-320-8275
Mailing Address - Fax:704-973-7862
Practice Address - Street 1:1536 FORDING ISLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-1144
Practice Address - Country:US
Practice Address - Phone:843-837-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16709225X00000X
SC7144225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7144OtherSTATE OF SOUTH CAROLINA
NC16709OtherSTATE OF NORTH CAROLINA