Doctor Name: | MRS. PEGGY DARMODY |
NPI Number: | 1659491850 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRC |
License Number: | 00010978 |
Business Practice Address: | 1025 Dodd Rd West Saint Paul, MN - 551181113 |
Business Phone Number: | 6514502220 |
Business Fax Number: | |
Mailing Address: | 591 Mercury Cir, SHOREVIEW |
State: | MN |
Postal Code: | 551262030 |
Phone Number: | 6514863887 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 00010978 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |