Organization
ALISHA PECK, LMSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISHA PECK-MUMA (OWNER/THERAPIST)
(231) 330-2303
Entity
Organization
Contact information
Practice address
668 STATE ST, BOYNE CITY, MI 49712-9129
(231) 330-2303
Mailing address
668 STATE ST, BOYNE CITY, MI 49712-9129
(231) 330-2303
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VS0047322
—
MI
Enumeration date
08/12/2022
Last updated
08/12/2022
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