Provider Demographics
NPI:1326193145
Name:UNRUH, PEGGY A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:A
Last Name:UNRUH
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 1:17171 PARK ROW
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-4927
Mailing Address - Country:US
Mailing Address - Phone:281-398-2509
Mailing Address - Fax:281-398-2688
Practice Address - Street 1:17171 PARK ROW
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-4927
Practice Address - Country:US
Practice Address - Phone:281-398-2509
Practice Address - Fax:281-398-2688
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical