Individual
BETHANY ANNE PETROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
15222 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230-1314
(313) 825-2403
Mailing address
1423 FIELD ST, DETROIT, MI 48214-2321
(313) 825-2421
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802091198
MI
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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