Provider Demographics
NPI:1851672901
Name:PECK, CHRISTOPHER ELSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ELSON
Last Name:PECK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 DOWNING DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILLS
Mailing Address - State:UT
Mailing Address - Zip Code:84062-8653
Mailing Address - Country:US
Mailing Address - Phone:801-404-4613
Mailing Address - Fax:
Practice Address - Street 1:233 S PLEASANT GROVE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2878
Practice Address - Country:US
Practice Address - Phone:801-785-4622
Practice Address - Fax:801-785-4623
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7427659-2501103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling