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Individual

MR. RODERICK DEJUAN PETERSON SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LLPC, CAAC, CCSM

Contact information

Practice address
7845 MIDDLEBELT RD STE 201, ROMULUS, MI 48174-2174
(734) 721-0900
Mailing address
7845 MIDDLEBELT RD STE 201, ROMULUS, MI 48174-2174
(734) 721-0900

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-00234
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
S-10019
MI
101YP2500X
Professional Counselor
Primary
1972368
MI

Other

Enumeration date
02/20/2008
Last updated
02/20/2008
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