| Organization Name: | DAVID E PEACO,PHD,LLC |
| NPI Number: | 1114384815 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID E PEACO (SOLE MEMBER) |
| Mailing Address: | 600 Medical Dr Ste 205 Wentzville |
| State: | MO US |
| Postal Code: | 633853426 |
| Phone Number: | 6363325050 |
| Fax Number: | 6363274723 |
| NPI Enumeration Date: | 01/26/2016 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 01175 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |