Provider Demographics
NPI:1992046742
Name:HANSELL, PEGGY SONYA (LBMT)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:SONYA
Last Name:HANSELL
Suffix:
Gender:F
Credentials:LBMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 LEGION RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8411
Mailing Address - Country:US
Mailing Address - Phone:910-425-8800
Mailing Address - Fax:
Practice Address - Street 1:3620 LEGION RD
Practice Address - Street 2:209
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8412
Practice Address - Country:US
Practice Address - Phone:910-568-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11967225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist