Individual
MRS. RENEE PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
2300 GALLBERRY LN, WAXHAW, NC 28173-0161
(704) 649-4509
Mailing address
2041 WHITE CEDAR LN, WAXHAW, NC 28173-8088
(828) 713-3118
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15532
NC
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
15532
NC
225XP0200X
Pediatric Occupational Therapist
Primary
15532
NC
Other
Enumeration date
10/28/2022
Last updated
07/16/2026
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