Individual
MR. CONARD PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1263 COBB PKWY N, MARIETTA, GA 30062-2421
(678) 636-9471
Mailing address
9065 BROCKHAM WAY, ALPHARETTA, GA 30022-8505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
010105
GA
Other
Enumeration date
05/21/2020
Last updated
01/05/2023
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