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General NPI Number Information
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NPI Number | 1770669905
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Entity Type | Individual
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Provider Name | ANDREA MARIE PELTIER MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 300 CROOKS STREET
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City | GREEN BAY
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State | WI
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Zip | 54301
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Country | US
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Telephone | 920-436-6800
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Fax | 920-432-5966
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Provider Business Mailing Address
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Address Line | PO BOX 22308
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City | GREEN BAY
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State | WI
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Zip | 54305-2308
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Country | US
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Telephone | 920-436-6800
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Fax | 920-432-5966
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8712
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License Number State | WI
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