Provider Demographics
NPI:1952779837
Name:PELTZER, AMINAH (PLPC)
Entity Type:Individual
Prefix:
First Name:AMINAH
Middle Name:
Last Name:PELTZER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3703
Mailing Address - Country:US
Mailing Address - Phone:816-587-4100
Mailing Address - Fax:816-587-6691
Practice Address - Street 1:400 E 6TH ST
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3703
Practice Address - Country:US
Practice Address - Phone:816-587-4100
Practice Address - Fax:816-587-6691
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015029918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional