Provider Demographics
NPI:1205725462
Name:PEEVYHOUSE, SAVANNAH MARCELL
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARCELL
Last Name:PEEVYHOUSE
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 1:1221 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:OK
Mailing Address - Zip Code:73542-2215
Mailing Address - Country:US
Mailing Address - Phone:580-335-1382
Mailing Address - Fax:
Practice Address - Street 1:1221 N 15TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:OK
Practice Address - Zip Code:73542-2215
Practice Address - Country:US
Practice Address - Phone:580-335-1382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRBT-25-446062103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst