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Search › Michigan › 1041C0700X

Carly Petroelje

NPI 1548641319 · on the registry since 2015

Practice

Address
790 Fuller Ave Ne
Grand Rapids, MI 49503
Phone
(616) 336-3909
Organisation at this address
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Inferred from a shared address, not stated in the registry.
Clinicians at this address
389

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-06-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan