Healthcare Provider Details

I. General information

NPI: 1144396433
Provider Name (Legal Business Name): PEGGY JO ZACHER PSY S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17835 N 44TH ST
PHOENIX AZ
85032-1516
US

IV. Provider business mailing address

19601 N 7TH ST UNIT 2062
PHOENIX AZ
85024-1647
US

V. Phone/Fax

Practice location:
  • Phone: 602-493-6120
  • Fax: 602-493-6125
Mailing address:
  • Phone: 602-493-6120
  • Fax: 602-493-6125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: