| NPI | 1518311794 |
|---|---|
| Former Name | HEATHER L PECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013926) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701006545) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2024-04-04 |