Provider Demographics
NPI:1215164017
Name:PEOPLES, BOBBIE (AT)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 E RIVER PL STE 900
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3442
Mailing Address - Country:US
Mailing Address - Phone:697-251-5550
Mailing Address - Fax:769-251-5590
Practice Address - Street 1:522 W PARK AVE STE Q-R
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-2906
Practice Address - Country:US
Practice Address - Phone:662-374-5029
Practice Address - Fax:662-374-5032
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor