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Individual
MR. ROBIN ROSS PEACOCK
Active
Individual
MR. ROBIN ROSS PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
138819-6006
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876000308007
—
UT
Enumeration date
04/24/2007
Last updated
07/08/2007
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