Provider Demographics
NPI:1639845670
Name:PEAUCELLE, ANNE-LAURE (C-IAYT, RYT)
Entity Type:Individual
Prefix:
First Name:ANNE-LAURE
Middle Name:
Last Name:PEAUCELLE
Suffix:
Gender:F
Credentials:C-IAYT, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E PAULINE DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-8347
Mailing Address - Country:US
Mailing Address - Phone:503-752-9310
Mailing Address - Fax:
Practice Address - Street 1:1071 E OLD CANYON CT STE 200
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5918
Practice Address - Country:US
Practice Address - Phone:503-752-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist