Provider Demographics
NPI:1164006078
Name:PEAKES, ANITA LYNNE
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:LYNNE
Last Name:PEAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ROSEN DR APT 3-202
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-2006
Mailing Address - Country:US
Mailing Address - Phone:970-481-3424
Mailing Address - Fax:
Practice Address - Street 1:2001 ROSEN DR APT 3-202
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-2006
Practice Address - Country:US
Practice Address - Phone:970-481-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health