James Michael Peterson
James Michael Peterson is a Developmental Therapist in Rockford, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2024
- Specialties on file
- 2
Practice location Address checks out
405 Welty AveRockford, IL 61107-4562
Phone: (779) 221-6395
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Specialties & licences
| Developmental Therapist (primary) | Taxonomy 222Q00000X (IL) |
|---|---|
| Developmental Therapist | Taxonomy 222Q00000X |
Record details
| NPI number | 1619784493 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | December 16, 2024 |
| Last updated in NPPES | December 16, 2024 |
| Certification date | December 15, 2024 |
| Mailing address | 405 Welty Ave, Rockford, IL 61107-4562 |
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