Provider Demographics
NPI:1396926648
Name:PEACH, ELIZABETH ELAINE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ELAINE
Last Name:PEACH
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ELAINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 11020 FETAL CARE CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-6289
Mailing Address - Fax:513-636-5959
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 11020 FETAL CARE CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-6289
Practice Address - Fax:513-636-5959
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS