Provider Demographics
NPI:1134736648
Name:PEED, KATLYNN NOEL
Entity type:Individual
Prefix:
First Name:KATLYNN
Middle Name:NOEL
Last Name:PEED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6900
Mailing Address - Country:US
Mailing Address - Phone:410-845-1602
Mailing Address - Fax:
Practice Address - Street 1:9730 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1154
Practice Address - Country:US
Practice Address - Phone:410-629-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool