MEDICARE: HANNAH PEAVLER LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker
2	106H00000X	Marriage & Family Therapist	9890894-3902	UT

General Provider Information

NPI Number	:	1174953038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH PEAVLER LMFT

Provider Business Mailing Address
First Line	:	5796 S 900 E
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-1036
Country	:	US
Telephone Number	:	385-436-2075
Fax Number	:

Provider Business Practice Location Address
First Line	:	5802 S 900 E
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84121-1644
Country	:	US
Telephone Number	:	385-436-2075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2013
Last Update Date	:	11/28/2022

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Directions to “ HANNAH PEAVLER LMFT” Practice Location

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