Organization
CREATING A DIFFERENCE
Active
Organization
CREATING A DIFFERENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIR ALLEN DUPREE PEGUES M.ED., LPC, NCC (LICENSED PROFESSIONAL COUNSELOR)
(770) 882-5895
Entity
Organization
Contact information
Practice address
1333 MOUNT ZION RD, MORROW, GA 30260-2357
(770) 882-5895
Mailing address
413 ARBOR CIR, TUCKER, GA 30084-8603
(770) 882-5895
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
008654
GA
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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