Individual
DEBORAH PECKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
57A INDIAN LN, CANTON, MA 02021-3540
(617) 970-6681
(781) 989-4772
Mailing address
57A INDIAN LN, CANTON, MA 02021-3540
(617) 970-6681
(781) 989-4772
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1031065
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P07929
BCBS PROVIDER #
MA
Enumeration date
01/30/2007
Last updated
07/08/2007
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