Provider Demographics
NPI:1093387086
Name:PEGGY THORNTON, PH.D., LLC
Entity Type:Organization
Organization Name:PEGGY THORNTON, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-789-8698
Mailing Address - Street 1:441 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1154
Mailing Address - Country:US
Mailing Address - Phone:205-789-8698
Mailing Address - Fax:
Practice Address - Street 1:3 OFFICE PARK CIR STE 310
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2536
Practice Address - Country:US
Practice Address - Phone:205-789-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-11
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health