Peck, Shannon Burton
Peck, Shannon Burton is an individual health care provider with primary practice located at 510 E Stoner Ave , Shreveport LA 71101-4243. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Peck, Shannon Burton can be contacted via phone (318) 990-4957.Contact Information
Primary practice address
510 E Stoner Ave
Shreveport LA 71101-4243
Phone: (318) 990-4957
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 32882 | Texas |
Profile Details
| NPI number | 1902963929 |
|---|---|
| LBN Legal business name | Peck, Shannon Burton |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Aug 2nd, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902963929 | NPPES |
| Texas | MEDICAID | 177186701 |
Popular Providers
-
Street, Jeanne
610 Herndon Ave , Shreveport LA 71101 -
Pinkston, James B
1501 Kings Hwy , Shreveport LA 71103-4228 -
Rhea, Milton
510 E. Stoner Ave , Shreveport LA 71101 -
Hollenshead, Jean Hunter
820 Jordan St Suite J, Shreveport LA 71101-4518 -
Yetman, Michelle
1450 Claiborne Ave Lsuhsc-Allied Health Clinics, Shreveport LA 71103-4204 -
Jennings, Tiffany Ann
920 Pierremont Rd Ste 205, Shreveport LA 71106-2093 -
Nelson, Dayna Marie
8873 Quimper Pl , Shreveport LA 71105-5620 -
Leblang, Jeffrey Herman
510 E Stoner Ave , Shreveport LA 71101-4243