Provider Demographics
NPI:1306827209
Name:UTECHT, PEGGY DIANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:DIANE
Last Name:UTECHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BRANARD ST
Mailing Address - Street 2:2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5015
Mailing Address - Country:US
Mailing Address - Phone:713-529-0037
Mailing Address - Fax:713-526-4367
Practice Address - Street 1:401 BRANARD ST
Practice Address - Street 2:2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5015
Practice Address - Country:US
Practice Address - Phone:713-529-0037
Practice Address - Fax:713-526-4367
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX297761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical