Individual
MEGAN PEACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3707 DOTY RD STE G, WOODSTOCK, IL 60098
(815) 338-6600
(815) 206-2822
Mailing address
3707 DOTY RD STE G, WOODSTOCK, IL 60098-7530
(815) 338-6600
(815) 206-2822
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009414
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071009414
STATE LICENSE
IL
Enumeration date
09/18/2008
Last updated
10/19/2018
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