Provider Demographics
NPI:1336893122
Name:PELT, DILAINA (LLPC)
Entity Type:Individual
Prefix:
First Name:DILAINA
Middle Name:
Last Name:PELT
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 VALDOSTA CIR
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-1083
Mailing Address - Country:US
Mailing Address - Phone:248-622-0636
Mailing Address - Fax:
Practice Address - Street 1:91 N SAGINAW ST STE G-101
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2165
Practice Address - Country:US
Practice Address - Phone:248-977-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health