| Doctor Name: | VICTORIA PELTON |
| NPI Number: | 1235416439 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LLP |
| License Number: | 6301014618 |
| Business Practice Address: | 1403 60th St Se Kentwood, MI - 495087065 |
| Business Phone Number: | 6167194488 |
| Business Fax Number: | 6167194480 |
| Mailing Address: | 1403 60th St Se, KENTWOOD |
| State: | MI |
| Postal Code: | 495087065 |
| Phone Number: | 6167194488 |
| Fax Number: | 6167194480 |
| NPI Enumeration Date: | 11/16/2011 |
| NPI Last Update Date: | 09/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301014618 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |