Provider Demographics
NPI:1912156860
Name:PEEK, PEGGY RANEY (MACCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:RANEY
Last Name:PEEK
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-5836
Mailing Address - Country:US
Mailing Address - Phone:501-223-8533
Mailing Address - Fax:
Practice Address - Street 1:1607 MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-5836
Practice Address - Country:US
Practice Address - Phone:501-223-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#175235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR906478565OtherDRIVER'S LICENSE