Provider Demographics
NPI:1700056488
Name:PEYERL, JEANINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:PEYERL
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 1:1701 4TH AVE SOUTH
Mailing Address - Street 2:JEFFERSON ELEMENTARY
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-446-4700
Mailing Address - Fax:701-446-4799
Practice Address - Street 1:1701 4TH AVE SOUTH
Practice Address - Street 2:JEFFERSON ELEMENTARY
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1562
Practice Address - Country:US
Practice Address - Phone:701-446-4700
Practice Address - Fax:701-446-4799
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND648225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist