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General NPI Number Information
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NPI Number | 1124167119
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Entity Type | Individual
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Provider Name | PEGGY COHEN LM
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 2907 SOUTH RD
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City | WILLISTON
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State | VT
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Zip | 05495-8882
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Country | US
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Telephone | 802-879-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 SOUTH RD
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City | WILLISTON
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State | VT
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Zip | 05495-8882
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Country | US
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Telephone | 802-879-1115
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 1070000004
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-305240
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License Number State |
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