Provider Demographics
NPI:1548570732
Name:MORNINGSTAR, PEGGY ANN (BS)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:ANN
Last Name:MORNINGSTAR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 471
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46384
Mailing Address - Country:US
Mailing Address - Phone:219-462-0513
Mailing Address - Fax:219-464-7828
Practice Address - Street 1:325 SOUTH 150 EAST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383
Practice Address - Country:US
Practice Address - Phone:219-462-0513
Practice Address - Fax:219-464-7828
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst