Provider Demographics
NPI:1104192517
Name:PEIGH, PILAR ROMSOS (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:PILAR
Middle Name:ROMSOS
Last Name:PEIGH
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 N CALVIN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-4613
Mailing Address - Country:US
Mailing Address - Phone:603-459-9257
Mailing Address - Fax:
Practice Address - Street 1:628 N CALVIN PARK BLVD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4613
Practice Address - Country:US
Practice Address - Phone:603-459-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist