Carissa Peppard, OTR

Individual provider Active NPI Occupational Therapist · Effort, PA

NPI 1992849145 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992849145
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OC-009836 (PA)
Practice address
1621 Starry LN
Effort, PA 18330-9748
Phone
(570) 629-6793
Fax
(570) 424-2346
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OC-009836PAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC-009836 PA Yes

Addresses

Primary practice location

1621 Starry LN
Effort, PA 18330-9748

Mailing address

1621 Starry LN
Effort, PA 18330-9748
Phone (570) 629-6793

Other identifiers

IdentifierTypeStateIssuer
101785863MedicaidPA

Other providers in Effort, PA

All providers in Effort, PA · Occupational Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.