Individual
GRETCHEN H PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMFT
Contact information
Practice address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779
Mailing address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC001611
GA
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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