Provider Demographics
NPI:1326036252
Name:PECK, DAWN (MS, CGC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:PECK
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 N KEENE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6986
Mailing Address - Country:US
Mailing Address - Phone:573-884-5192
Mailing Address - Fax:573-884-4105
Practice Address - Street 1:402 N KEENE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6986
Practice Address - Country:US
Practice Address - Phone:573-884-5192
Practice Address - Fax:573-884-4105
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS