Provider Demographics
NPI:1649829573
Name:ZINSER, PEGGY (PHD)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:ZINSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:KALTENBACH, KALTENBACH-PINGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1861
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:6300 N HAGGERTY RD STE 100
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4472
Practice Address - Country:US
Practice Address - Phone:734-738-1900
Practice Address - Fax:734-738-1905
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007472103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical