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1538326244
STACEY LYNN PETERSON
TAMPA, FL
NPI
1538326244
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MI 6301010935)
Enumeration Date
2008-05-20
Last Update Date
2017-11-20
Business Address
Ms. STACEY LYNN PETERSON MS
10909 MEMORIAL HWY
TAMPA, FL 33615-2511
Phone number: 813-855-4435
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Mailing Address
Ms. STACEY LYNN PETERSON MS
79 W ALEXANDRINE ST
DETROIT, MI 48201-2015
Phone number: 313-831-5535
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