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Individual

KATY PELOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2700 HAMLIN BLVD, INKSTER, MI 48141-2206
(313) 561-5100
Mailing address
557 ACADEMY ST, FERNDALE, MI 48220-3316
(313) 995-6969

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401015710
MI
101YP2500X
Professional Counselor
Primary
6401018009
MI
171M00000X
Case Manager/Care Coordinator
6803086711
MI

Other

Enumeration date
05/28/2015
Last updated
01/07/2020
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