Peck, Laticia

Peck, Laticia is an sole proprietor health care provider with primary practice located at 1165 Pine Lake Dr , Grayson GA 30017-7926. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Peck, Laticia can be contacted via phone (678) 852-4022.

Contact Information

Primary practice address
1165 Pine Lake Dr Grayson GA 30017-7926
Fax: (770) 972-5577
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005865 Georgia

Profile Details

NPI number 1104804574
LBN Legal business name Peck, Laticia
Credentials SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 5th, 2006
Last updated Apr 28th, 2009 - about 17 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 1104804574 NPPES
Georgia MEDICAID 371442378F

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