Provider Demographics
NPI:1699129486
Name:PEEK, AKEISHA DANIELLE
Entity type:Individual
Prefix:MS
First Name:AKEISHA
Middle Name:DANIELLE
Last Name:PEEK
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 1:503 GAINEY DR
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:42262-8259
Mailing Address - Country:US
Mailing Address - Phone:270-987-8750
Mailing Address - Fax:
Practice Address - Street 1:503 GAINEY DR
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:KY
Practice Address - Zip Code:42262-8259
Practice Address - Country:US
Practice Address - Phone:270-987-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9569OtherAKEISHA PEEK