Individual
MS. STACEY LYNN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LLP
Contact information
Practice address
18316 MIDDLEBELT RD, LIVONIA, MI 48152-5007
(248) 615-9730
Mailing address
32266 LEELANE, FARMINGTON, MI 48336-2429
(248) 672-8292
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361000945
MI
Other
Enumeration date
05/20/2008
Last updated
05/11/2026
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