Individual
DR. DAVID MICHAEL VAN PELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
903 S KINGSHIGHWAY ST, SIKESTON, MO 63801-4415
(573) 472-2139
(573) 472-6457
Mailing address
903 S KINGSHIGHWAY ST, SIKESTON, MO 63801-4415
(573) 472-2139
(573) 472-6457
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MO2005015544
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499322014
—
MO
01
—
SDA3992113
CHILD TREATMENT SERVICES
MO
Enumeration date
03/10/2006
Last updated
02/28/2014
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