Shannon Burton Peck in Shreveport - Clinical
Shannon Burton Peck - NPI 1902963929
Shannon Burton Peck is a Clinical in Shreveport, Louisiana. Shannon Burton Peck practices all healthcare services and medical treatments related to Clinical. The NPI Number for Shannon Burton Peck is 1902963929. The last update date is 2013-08-02.
Shannon Burton Peck's current location address is 510 E Stoner Ave, Shreveport, Louisiana. You can contact this provider via phone number 3189904957. The mailing address for Shannon Burton Peck is 510 E Stoner Ave, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Burton Peck |
|---|---|
| Address | 510 E Stoner Ave, Shreveport, Louisiana |
| Phone Number | 3189904957 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1902963929 |
|---|---|
| Provider Enumeration Date | 2007-01-02 |
| Last Updated Date | 2013-08-02 |
Provider Mailing Address Detail
| Address | 510 E Stoner Ave |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711014243 |
| Phone Number | 3189904957 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 32882 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identifier code assigned to Shannon Burton Peck by the Centers for Medicare & Medicaid Services?
The Shannon Burton Peck has been issued the NPI (National Provider Identifier) 1902963929 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Shannon Burton Peck is physically located?
The Shannon Burton Peck is physically situated at the following address: 510 E Stoner Ave, Shreveport, LA, 711014243.
What is Shannon Burton Peck's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Shannon Burton Peck is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
When was the Shannon Burton Peck's 1902963929 issued?
The Shannon Burton Peck's 1902963929 was issued on 2007-01-02.
As of what date was the information pertaining to Shannon Burton Peck, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Shannon Burton Peck, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-08-02.