Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2-1953 | TX |
N | 103TC0700X | Clinical Psychologist | 2-1953 | TX |
Y | 102L00000X | Psychologist | 2-1953 | TX |
Y | 103T00000X | Psychologist | 2-1953 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 21953 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 21953 | TX |
N | 103TF0000X | Family Psychologist | 21953 | TX |
N | 103TF0200X | Forensic Psychologist | 21953 | TX |
N | 103TM1800X | Intellectual & Developmental Disabilities | 21953 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 21953 | TX |
NPI | 1255351177 |
---|---|
Provider Name | Leon Ashley Peek |
First Address | Denton, TX 76201-3747 |
Second Address | Denton, TX 76201-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 20/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P000TN168 | (05) | TX |