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General NPI Number Information
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NPI Number | 1689398018
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Entity Type | Individual
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Provider Name | AMBER ROSE PETERS TLLP
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 3600 N SAGINAW RD
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City | MIDLAND
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State | MI
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Zip | 48640-2301
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Country | US
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Telephone | 989-510-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 2142 BROCKWAY ST
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City | SAGINAW
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State | MI
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Zip | 48602-2718
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Country | US
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Telephone | 989-327-9437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6362009635
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License Number State | MI
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