Individual
GENOVIA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1713 WEEPING WILLOW CT, SUPERIOR TOWNSHIP, MI 48198-1327
(734) 678-9509
Mailing address
1713 WEEPING WILLOW CT, SUPERIOR TOWNSHIP, MI 48198-1327
(734) 678-9509
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222328
MI
101YP2500X
Professional Counselor
6401222328
MI
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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