Provider Demographics
NPI:1447762273
Name:KILLOP, PEYTON ELIZABETH
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:ELIZABETH
Last Name:KILLOP
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 1:32715 DORSEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4755
Mailing Address - Country:US
Mailing Address - Phone:734-641-1141
Mailing Address - Fax:
Practice Address - Street 1:32715 DORSEY ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4755
Practice Address - Country:US
Practice Address - Phone:734-641-1141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)