Peterson, Brenden
Peterson, Brenden is an sole proprietor health care provider with primary practice located at 1000 E Tinkham Ave , Ludington MI 49431-1568. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Peterson, Brenden can be contacted via phone (231) 845-6291.Contact Information
Primary practice address
1000 E Tinkham Ave
Ludington MI 49431-1568
Phone: (231) 845-6291
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 7101004661 | Michigan |
Profile Details
| NPI number | 1114319860 |
|---|---|
| LBN Legal business name | Peterson, Brenden |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 3rd, 2015 |
| Last updated | Mar 3rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114319860 | NPPES |
| Michigan | MEDICAID | 1095263920 |
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