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1457570277
ROBIN ROSS PEACOCK
OGDEN, UT
NPI
1457570277
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT 138819-6006)
Enumeration Date
2007-04-24
Last Update Date
2007-07-08
Business Address
Mr. ROBIN ROSS PEACOCK LSAC
2127 LINCOLN AVE
OGDEN, UT 84401-1313
Phone number: 801-625-3686
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Mailing Address
Mr. ROBIN ROSS PEACOCK LSAC
5961 W 5050 S
HOOPER, UT 84315-9720
Phone number: 801-985-9891
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