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General NPI Number Information
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NPI Number | 1093814824
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Entity Type | Individual
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Provider Name | PEGGY WOEHRLEN LMSW, LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 30231 CANTERBURY DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-1201
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Country | US
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Telephone | 248-701-4977
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Fax | 248-723-9469
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Provider Business Mailing Address
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Address Line | 18090 MACK AVE
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City | GROSSE POINTE
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State | MI
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Zip | 48230-6251
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Country | US
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Telephone | 248-701-4977
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Fax | 313-642-1998
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801005123
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101005894
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License Number State | MI
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