Doctor Name: | DR. THOMAS ROGER PEAY |
NPI Number: | 1073791729 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 113517-3902 |
Business Practice Address: | 2559 Aspen Springs Dr Park City, UT - 840607538 |
Business Phone Number: | 8013768775 |
Business Fax Number: | 4356040461 |
Mailing Address: | 2559 Aspen Springs Dr, PARK CITY |
State: | UT |
Postal Code: | 840607538 |
Phone Number: | 8013768775 |
Fax Number: | 4356040461 |
NPI Enumeration Date: | 02/05/2008 |
NPI Last Update Date: | 02/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 113517-3902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |