Individual
DAVID PERADOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Mailing address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301008098
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273178
VO
MI
01
—
300040030
NPC TAX ID
MI
01
—
680F321030
BC PIN
MI
01
—
680F333060
BC PIN
MI
Enumeration date
06/30/2006
Last updated
08/21/2008
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