Provider Demographics
NPI:1801938576
Name:KARLOSKY, PEGGY LOUANN (PHD)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:LOUANN
Last Name:KARLOSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 HEATHROW DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5552
Mailing Address - Country:US
Mailing Address - Phone:931-528-1361
Mailing Address - Fax:
Practice Address - Street 1:1716 HEATHROW DR
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-5552
Practice Address - Country:US
Practice Address - Phone:931-528-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001385103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN94690OtherBLUE CROSS BLUE SHIELD
TN94690OtherBLUE CROSS BLUE SHIELD