Provider Demographics
NPI:1316369366
Name:DEFRANGE, PEGGY
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:DEFRANGE
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 1:395 DEFRANGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:KREBS
Mailing Address - State:OK
Mailing Address - Zip Code:74554
Mailing Address - Country:US
Mailing Address - Phone:918-429-2667
Mailing Address - Fax:
Practice Address - Street 1:395 DEFRANGE DRIVE
Practice Address - Street 2:
Practice Address - City:KREBS
Practice Address - State:OK
Practice Address - Zip Code:74554
Practice Address - Country:US
Practice Address - Phone:918-429-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor