| NPI | 1093434193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ANN PETERSON Sole Member LLC Owner 530-262-7025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |