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General NPI Number Information
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NPI Number | 1205039286
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Entity Type | Individual
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Provider Name | SUSAN C PEACH M.S., L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 7661 MCLAUGHLIN RD #524
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City | PEYTON
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State | CO
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Zip | 80831-4727
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Country | US
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Telephone | 719-247-9751
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Fax | 888-782-5643
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Provider Business Mailing Address
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Address Line | 7661 MCLAUGHLIN RD #524
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City | PEYTON
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State | CO
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Zip | 80831-4727
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Country | US
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Telephone | 719-247-9751
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Fax | 888-782-5643
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4660
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License Number State | CO
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