| NPI | 1508802893 |
|---|---|
| Other Name | PHILLIP O PEGG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO PYT0122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1390) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-06-10 |