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Individual
MR. ROBERT C PEACH
Active
Individual
MR. ROBERT C PEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0001647
OH
1041C0700X
Clinical Social Worker
E0001647
OH
1041C0700X
Clinical Social Worker
F0000125
OH
106H00000X
Marriage & Family Therapist
F125
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503182
ANTHEM
OH
Enumeration date
12/18/2006
Last updated
09/27/2013
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