Provider Demographics
NPI:1083407209
Name:SYCAMORE PEDIATRIC THERAPY PLLC
Entity type:Organization
Organization Name:SYCAMORE PEDIATRIC THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIESTER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:828-329-2926
Mailing Address - Street 1:130 CHAPEL COVE RD
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-0727
Mailing Address - Country:US
Mailing Address - Phone:828-329-2926
Mailing Address - Fax:
Practice Address - Street 1:130 CHAPEL COVE RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-0727
Practice Address - Country:US
Practice Address - Phone:828-329-2926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty