Individual
DELISAH A PEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
250 DEWEY AVENUE, SPARTANBURG, SC 29303
(864) 585-0366
(864) 583-3136
Mailing address
250 DEWEY AVENUE, SPARTANBURG, SC 29303
(864) 585-0366
(864) 583-3136
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121328
—
SC
Enumeration date
10/06/2011
Last updated
10/06/2011
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