Provider Demographics
NPI:1205248564
Name:PECH, V
Entity type:Individual
Prefix:MR
First Name:V
Middle Name:
Last Name:PECH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KHAO DANG PROVINCE
Mailing Address - Street 2:
Mailing Address - City:REFUGEE CAMP
Mailing Address - State:KHAO DANG
Mailing Address - Zip Code:22210
Mailing Address - Country:TH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 WILDER ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1731
Practice Address - Country:US
Practice Address - Phone:978-452-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker