Provider Demographics
NPI:1831677962
Name:WINKLE, PEGGY ANN (IECE)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANN
Last Name:WINKLE
Suffix:
Gender:F
Credentials:IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:OWENTON
Mailing Address - State:KY
Mailing Address - Zip Code:40359-9444
Mailing Address - Country:US
Mailing Address - Phone:502-682-9275
Mailing Address - Fax:
Practice Address - Street 1:8505 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359-9444
Practice Address - Country:US
Practice Address - Phone:502-682-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist