Individual
TASHA MARIA PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5332 HOLLYWOOD AVE, MAPLE HEIGHTS, OH 44137
(330) 983-7422
Mailing address
671 VERNON ODOM BLVD, AKRON, OH 44307-1867
(330) 983-7422
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
OH
172V00000X
Community Health Worker
Primary
CHW002436
OH
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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