Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 365000 | TX |
N | 103T00000X | Psychologist | 365000 | TX |
Y | 103TC1900X | Counseling Psychologist | 365000 | TX |
N | 103TP2701X | Group Psychotherapist | 365000 | TX |
NPI | 1083072987 |
---|---|
Provider Name | Dr. Andreka Peat |
First Address | Plano, TX 75075 |
Second Address | Mckinney, TX 75071-5515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2016 |
Last Update Date | 05/02/2016 |