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Contact Information

CORRIE J PELTIER, LADC
31065 FOREST BLVD.
STACY, MN55079
 Phone: 650-408-7121
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for CORRIE J PELTIER · (Male)

NPI # 1114070406
Status Active
Credentials LADC
Entity Individual
Enumeration date 01/19/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 1032392-1-CDT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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