Individual
KATHERINE L PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
4190 W 4695 S, WEST VALLEY, UT 84120-6062
(801) 702-0842
Mailing address
4190 WEST 4695 SOUTH, WEST VALLEY, UT 84120
(801) 702-0842
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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