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General NPI Number Information
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NPI Number | 1043684509
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Entity Type | Individual
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Provider Name | SHANI PEEBLES
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Gender | Female
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 7400 BEAUFONT SPRINGS DR SUITE 300
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-5556
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Country | US
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Telephone | 252-333-4787
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Fax |
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Provider Business Mailing Address
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Address Line | 7400 BEAUFONT SPRINGS DR SUITE 300
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-5556
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Country | US
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Telephone | 252-333-4787
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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