Individual
DR. PEGGY PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
802 N UNIVERSITY AVE, LITTLE ROCK, AR 72205-2920
(501) 420-2434
(888) 388-5166
Mailing address
802 N UNIVERSITY AVE, LITTLE ROCK, AR 72205-2920
(501) 420-2434
(888) 388-5166
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0785
KY
103TC0700X
Clinical Psychologist
Primary
11-11P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000033491
ANTHEM
KY
01
—
11386583
HEALTHLINK
AR
01
—
1200633
CHA
KY
01
—
12020012900
QUALCHOICE
AR
01
—
13386583
HEALTHLINK
AR
05
—
190865719
—
AR
01
—
5V939
AR BCBS
AR
01
—
HUKY0818
CORPHEALTH
KY
01
—
P01014233
RR MEDICARE
AR
Enumeration date
12/03/2005
Last updated
07/23/2014
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