Provider Demographics
NPI:1447570536
Name:PELLETTIERE, VICTORIA MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MARY
Last Name:PELLETTIERE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 JOYCE RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60436-1876
Mailing Address - Country:US
Mailing Address - Phone:815-741-7019
Mailing Address - Fax:
Practice Address - Street 1:777 JOYCE RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60436-1876
Practice Address - Country:US
Practice Address - Phone:815-741-7019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst