Provider Demographics
NPI:1437509866
Name:IGLEHART, PEGGY G (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:G
Last Name:IGLEHART
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 CLARKSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-8015
Mailing Address - Country:US
Mailing Address - Phone:903-784-7702
Mailing Address - Fax:903-784-7703
Practice Address - Street 1:3166 CLARKSVILLE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-8015
Practice Address - Country:US
Practice Address - Phone:903-784-7702
Practice Address - Fax:903-784-7703
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12136235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist