Provider Demographics
NPI:1306176185
Name:PEEL, MARTI LOUANN (MHPP)
Entity type:Individual
Prefix:MRS
First Name:MARTI
Middle Name:LOUANN
Last Name:PEEL
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 COUNTY ROAD 534
Mailing Address - Street 2:
Mailing Address - City:MONETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72447-9197
Mailing Address - Country:US
Mailing Address - Phone:870-974-3244
Mailing Address - Fax:
Practice Address - Street 1:1217 STONE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4520
Practice Address - Country:US
Practice Address - Phone:870-561-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator