Organization Name: | DENNIS PELON PHD, PC |
NPI Number: | 1265532576 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENNIS PELON (OWNER) |
Mailing Address: | 1640 Haslett Rd Suite 110 Haslett |
State: | MI US |
Postal Code: | 488408691 |
Phone Number: | 5173391686 |
Fax Number: | 5173393286 |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 6301002693 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |