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General NPI Number Information
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NPI Number | 1750204236
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Entity Type | Individual
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Provider Name | PEYTON PLATTE
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Gender | Male
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 4050 DEL MAR DR SW
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City | WYOMING
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State | MI
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Zip | 49418-8870
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Country | US
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Telephone | 616-317-4807
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Fax |
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Provider Business Mailing Address
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Address Line | 1282 SAFFRON LN SE APT 3B
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-7350
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Country | US
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Telephone | 616-317-4807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6362010347
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License Number State | MI
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