Provider Demographics
NPI:1487943940
Name:PEEBLES, LAURIE FRASER
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:FRASER
Last Name:PEEBLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 KENDEMERE POINTE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7667
Mailing Address - Country:US
Mailing Address - Phone:803-940-2597
Mailing Address - Fax:
Practice Address - Street 1:380 KENDEMERE POINTE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7667
Practice Address - Country:US
Practice Address - Phone:803-940-2597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist