Individual
TAJUANA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11258 WAYBURN ST, DETROIT, MI 48224-1634
(313) 529-1253
Mailing address
11258 WAYBURN ST, DETROIT, MI 48224-1634
(313) 529-1253
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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