Individual
DR. TAMMY ELLEN PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LCSW
Contact information
Practice address
301 ANDREW AVENUE, FORT RUCKER, AL 36362-5333
(334) 255-7010
(334) 255-7617
Mailing address
301 ANDREWS AVE, FT. RUCKER, AL 36362
(334) 255-7010
(334) 255-7617
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
290
AL
1041C0700X
Clinical Social Worker
Primary
1012C
AL
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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