Provider Demographics
NPI:1902387616
Name:PEAGLER, PEGGY (PHD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:PEAGLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 E CAPITOL ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1259
Mailing Address - Country:US
Mailing Address - Phone:202-546-5934
Mailing Address - Fax:
Practice Address - Street 1:2725 10TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1754
Practice Address - Country:US
Practice Address - Phone:202-281-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool