Individual
BRYAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LLP
Contact information
Practice address
1098 ANN ARBOR RD W # 2491, PLYMOUTH, MI 48170-2129
(248) 560-7561
Mailing address
1098 ANN ARBOR RD W # 2491, PLYMOUTH, MI 48170-2129
(248) 560-7561
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361007552
MI
Other
Enumeration date
08/24/2017
Last updated
07/10/2023
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