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Destiny Peterson
Specialist in Southfield, Michigan
NPI 1366831273

Destiny Peterson is a Specialist based in Southfield, MI. Destiny Peterson practices in Southfield, MI. The NPI Number for Destiny Peterson is 1366831273 and holds a License No. 7501000917 (Michigan).

The current practice location address for Destiny Peterson is 21415 Civic Center Dr Ste 209, Southfield, MI and can be reached out via phone at 248-703-2889.

Location: 21415 Civic Center Dr Ste 209, Southfield, MI, 48076-3943
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366831273
Provider Name
Destiny Peterson
Credential
Provider Entity Type
Individual
Gender
Female
Address
21415 Civic Center Dr Ste 209, Southfield, MI, 48076-3943
Phone Number
248-703-2889
Fax Number
Provider Enumeration Date
01/15/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7501000917 01 MI STATE OF MICHIGAN LICENSING BOARD NUMBER
institution
Provider Business Practice Location Address Details
Address
21415 Civic Center Dr Ste 209
City
Southfield
State
Michigan
Zip
48076-3943
Phone Number
248-703-2889
Fax Number
person
Provider Business Mailing Address Details
Address
21415 Civic Center Dr Ste 209
City
Southfield
State
Michigan
Zip
48076-3943
Phone Number
248-703-2889
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
7501000917 (Michigan)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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