Healthcare Provider Details

I. General information

NPI: 1184535528
Provider Name (Legal Business Name): KATELYN PETERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7454 B DR N
BATTLE CREEK MI
49014-8381
US

IV. Provider business mailing address

12559 H DR S
MARSHALL MI
49068-9257
US

V. Phone/Fax

Practice location:
  • Phone: 269-275-2125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: