| Doctor Name: | BRYAN DAVID PELTIER |
| NPI Number: | 1811346943 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 290 |
| Business Practice Address: | 125 Fox Hills Dr Green River, WY - 829357100 |
| Business Phone Number: | 3078711615 |
| Business Fax Number: | |
| Mailing Address: | 125 Fox Hills Dr, GREEN RIVER |
| State: | WY |
| Postal Code: | 829357100 |
| Phone Number: | 3078711615 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2016 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |