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1144585829
DAX W PETERSON
SALT LAKE CITY, UT
NPI
1144585829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 7285972-3501)
Enumeration Date
2012-07-10
Last Update Date
2012-07-10
Business Address
-- DAX W PETERSON LCSW
24 M ST
SALT LAKE CITY, UT 84103-3840
Phone number: 801-654-0862
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Mailing Address
-- DAX W PETERSON LCSW
3705 S KIMBARY WAY
SALT LAKE CITY, UT 84109-4024
Phone number: 801-654-0862
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