Most Relevant Information
Provider Data
| NPI Number: | 1003651043 |
| Provider Name: | KYLEIGH PETERSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/01/2024 |
| Last Updated: | 07/01/2024 |
Provider Practice Location
1001 S RAISINVILLE RD
MONROE
MI
481619754
Practice Location Phone/Fax
| Phone: | 7343840083 |
| Fax: |
Provider Mailing Location
1001 S RAISINVILLE RD
MONROE
MI
481619754
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |