Healthcare Provider Details

I. General information

NPI: 1902906910
Provider Name (Legal Business Name): PEGGY M O'STEEN MA LPC CCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N WALNUT ST
FLORENCE AL
35630-4754
US

IV. Provider business mailing address

208 N WALNUT STREET
FLORENCE AL
35630
US

V. Phone/Fax

Practice location:
  • Phone: 256-766-6858
  • Fax: 256-766-6807
Mailing address:
  • Phone: 256-766-6858
  • Fax: 256-766-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number641
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: