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1063707305
LISA M PETERSEN
COUNCIL BLUFFS, IA
NPI
1063707305
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: IA 001501)
Additional Taxonomies
101Y00000X Counselor
(Licence: NE 8871)
Enumeration Date
2011-06-15
Last Update Date
2015-08-03
Business Address
-- LISA M PETERSEN LMHP
801 HARMONY ST SUITE 302
COUNCIL BLUFFS, IA 51503-3106
Phone number: 712-328-2609
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Mailing Address
-- LISA M PETERSEN LMHP
7261 MERCY RD
OMAHA, NE 68124-2311
Phone number: 402-398-6248
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