Individual
KRISTINE A PETLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5675 FAIRVIEW ST, STEVENSVILLE, MI 49127-1033
(269) 429-7727
(269) 429-5754
Mailing address
5675 FAIRVIEW ST, STEVENSVILLE, MI 49127-1033
(269) 429-7727
(269) 429-5754
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301013815
MI
103T00000X
Psychologist
Primary
6361005132
MI
Other
Enumeration date
02/27/2008
Last updated
01/13/2025
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