Provider Demographics
NPI:1134370844
Name:FUHRMAN, PEGGY (MASTERS EDUCATION)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:FUHRMAN
Suffix:
Gender:F
Credentials:MASTERS EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1927
Mailing Address - Street 2:
Mailing Address - City:PAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:86040-1927
Mailing Address - Country:US
Mailing Address - Phone:928-608-4200
Mailing Address - Fax:928-645-5059
Practice Address - Street 1:500 S. NAVAJO
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-1927
Practice Address - Country:US
Practice Address - Phone:928-608-4200
Practice Address - Fax:928-645-5059
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2004949101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool