Individual
KOTRINA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6159 SOMERSET CT, GRAND BLANC, MI 48439-7447
(678) 516-2295
Mailing address
6159 SOMERSET CT, GRAND BLANC, MI 48439-7447
(678) 516-2295
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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