Individual
MRS. MICHELLE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DEVELOPMENTAL THERAP
Contact information
Practice address
579 RIFORD RD, GLEN ELLYN, IL 60137-4236
(630) 858-2336
(630) 942-0377
Mailing address
579 RIFORD RD, GLEN ELLYN, IL 60137-4236
(630) 858-2336
(630) 942-0377
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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