Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003137076 |
---|---|
Provider Name | Casey L Peck |
First Address | Lebanon, PA 17046-5040 |
Second Address | Reading, PA 19609-2054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 14/06/2010 |