Provider Demographics
NPI:1356169536
Name:PEACE AND EQUALITY THERAPY PC
Entity type:Organization
Organization Name:PEACE AND EQUALITY THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIBYL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:307-389-1041
Mailing Address - Street 1:231 E 400 S STE 370
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2832
Mailing Address - Country:US
Mailing Address - Phone:307-389-1041
Mailing Address - Fax:
Practice Address - Street 1:231 E 400 S STE 370
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2832
Practice Address - Country:US
Practice Address - Phone:307-389-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health