Individual
AARIN-EARL PESKO-MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, L/CPHT
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 555-1234
Mailing address
7350 COOLEY LAKE RD, WATERFORD, MI 48327-3864
(248) 942-3333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704334253
MI
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704334253
MI
Other
Enumeration date
09/24/2020
Last updated
03/06/2023
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