Pack, Peggy

Pack, Peggy is an sole proprietor health care provider with primary practice located at 802 N University Ave , Little Rock AR 72205-2920. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pack, Peggy can be contacted via phone (501) 420-2434.

Contact Information

Primary practice address
802 N University Ave Little Rock AR 72205-2920
Phone: (501) 420-2434
Fax: (888) 388-5166
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0785 Kentucky
Behavioral Health & Social Service Providers / Clinical 103TC0700X 11-11P Arkansas

Profile Details

NPI number 1740264639
LBN Legal business name Pack, Peggy
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2005
Last updated Jul 23rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740264639 NPPES
Arkansas Other P01014233 RR MEDICARE
Arkansas Other 1200633 RR MEDICARE
Arkansas Other 13386583 RR MEDICARE
Arkansas MEDICAID 190865719 RR MEDICARE
Arkansas Other 11386583 RR MEDICARE
Arkansas Other 5V939 RR MEDICARE
Arkansas Other HUKY0818 RR MEDICARE
Arkansas Other 12020012900 RR MEDICARE
Arkansas Other 000000033491 RR MEDICARE

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