Individual
LETICIA PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34590 COUNTY LINE RD STE 7, YUCAIPA, CA 92399-5398
(909) 795-4255
(909) 795-4438
Mailing address
34590 COUNTY LINE RD STE 7, YUCAIPA, CA 92399-5398
(909) 795-4255
(909) 795-4438
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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