Individual
JAMES MARTIN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BASW, CCM, CBIST
Contact information
Practice address
137 HOLTON WHITEHALL RD, WHITEHALL, MI 49461-9543
(231) 893-1462
Mailing address
PO BOX 281, WHITEHALL, MI 49461-0281
(231) 893-1462
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802010722
MI
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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