Individual
MR. LATRELL RASHOD PETERSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6615 HIGHLAND GREENS DR APT 215G, WEST CHESTER, OH 45069-7664
(734) 304-3084
Mailing address
6615 HIGHLAND GREENS DR APT 215G, WEST CHESTER, OH 45069-7664
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
VC597561
OH
3747P1801X
Personal Care Attendant
VC597561
OH
376J00000X
Homemaker
VC597561
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
VC597561
OH
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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