Individual
GWENDOLYN D PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3728 E MECATE RD, TUCSON, AZ 85739-8339
(810) 955-3819
Mailing address
3728 E MECATE RD, TUCSON, AZ 85739-8339
(810) 955-3819
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19061
AZ
Other
Enumeration date
09/30/2022
Last updated
09/30/2022
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