Individual
BETH A PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
211 BIEDE AVE, DEFIANCE, OH 43512-2408
(419) 782-8856
Mailing address
211 BIEDE AVE, DEFIANCE, OH 43512-2408
(419) 782-8856
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C0500418
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0500418
LICENSE
OH
Enumeration date
10/21/2008
Last updated
10/21/2008
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