Individual
KELSEY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5460 W ROLLING HILLS DR, BRIDGEPORT, MI 48722-9668
(989) 272-4500
(989) 272-4501
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
5201013406
MI
Other
Enumeration date
08/09/2017
Last updated
12/08/2025
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