Individual
BRENT PEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
13460 N 94TH DR, SUITE K3, PEORIA, AZ 85381-4835
(623) 974-3333
Mailing address
13460 N 94TH DR, SUITE K3, PEORIA, AZ 85381-4835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-5701
AZ
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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