Individual
MS. THERESA ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
337 GOLD AVE NW APT 3, GRAND RAPIDS, MI 49504-7502
(616) 337-1378
Mailing address
337 GOLD AVE NW APT 3, GRAND RAPIDS, MI 49504-7502
(616) 337-1378
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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