Provider Demographics
NPI:1053992347
Name:PLACK, ANNA BRIGGS (MSOT OTR/L)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:BRIGGS
Last Name:PLACK
Suffix:
Gender:F
Credentials:MSOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOYT RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9418
Mailing Address - Country:US
Mailing Address - Phone:828-329-9499
Mailing Address - Fax:
Practice Address - Street 1:6 HOYT RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9418
Practice Address - Country:US
Practice Address - Phone:828-329-9499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3151225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist