Provider Demographics
NPI: | 1427097245 |
---|---|
Name: | QUIRE, DRUE STRAUB (MOTRL) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | DRUE |
Middle Name: | STRAUB |
Last Name: | QUIRE |
Suffix: | |
Gender: | F |
Credentials: | MOTRL |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 34 N ENGLAND ST UNIT B |
Mailing Address - Street 2: | |
Mailing Address - City: | BREVARD |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28712-4312 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-727-1815 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 34 N ENGLAND ST UNIT B |
Practice Address - Street 2: | |
Practice Address - City: | BREVARD |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28712-4312 |
Practice Address - Country: | US |
Practice Address - Phone: | 027-271-8155 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-06 |
Last Update Date: | 2020-01-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 12811 | 225XG0600X, 225XP0019X, 225XP0200X, 225X00000X, 224ZL0004X, 225XE0001X, 225XF0002X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
No | 225XG0600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No | 224ZL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Low Vision |
No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification |
No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
000000221658 | Other | ANTHEM | |
4172212 | Medicare ID - Type Unspecified | ||
4172213 | Medicare ID - Type Unspecified | ||
000000221658 | Other | ANTHEM | |
4172211 | Medicare ID - Type Unspecified |