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Individual

AMI MARIE PEACOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW-S

Contact information

Practice address
921 CHATHAM LN STE 112, COLUMBUS, OH 43221-2418
(614) 754-7648
Mailing address
1330 LANE ON THE LK, COLUMBUS, OH 43235-7580
(216) 408-9497

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0009629
OH

Other

Enumeration date
04/20/2012
Last updated
04/20/2012
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