Healthcare Provider Details

I. General information

NPI: 1972460954
Provider Name (Legal Business Name): ALAINA PEACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

IV. Provider business mailing address

1250 E MARSHALL ST
RICHMOND VA
23298-5023
US

V. Phone/Fax

Practice location:
  • Phone: 734-205-7225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4704365951
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: