Provider Demographics
NPI:1952722399
Name:HUOT, PEGGY
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:HUOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:HUOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:4872 GRENWICH TRL N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-2029
Mailing Address - Country:US
Mailing Address - Phone:612-501-2274
Mailing Address - Fax:
Practice Address - Street 1:402 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-4400
Practice Address - Country:US
Practice Address - Phone:651-266-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN149991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical