Adzagah, Mendocino Nicole Peacock

Adzagah, Mendocino Nicole Peacock is an individual health care provider with primary practice located at 5770 S Fashion Boulevard Building 5 Suite 210, Murray UT 84107. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Adzagah, Mendocino Nicole Peacock can be contacted via phone (833) 577-3422.

Contact Information

Primary practice address
5770 S Fashion Boulevard Building 5 Suite 210 Murray UT 84107
Phone: (833) 577-3422
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X CF7205 New Mexico

Profile Details

NPI number 1891360970
LBN Legal business name Adzagah, Mendocino Nicole Peacock
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2021
Last updated Oct 18th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891360970 NPPES
Other . NONE

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