Individual
MR. KELLY PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 234-7521
(662) 236-3071
Mailing address
801 FRONTAGE RD, APT. 613, OXFORD, MS 38655-5123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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