DAX W PETERSON

SALT LAKE CITY, UT
NPI1144585829
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: UT  7285972-3501)
Enumeration Date2012-07-10
Last Update Date2012-07-10
Business Address
-- DAX W PETERSON LCSW
24 M ST
SALT LAKE CITY, UT 84103-3840
Phone number: 801-654-0862
Mailing Address
-- DAX W PETERSON LCSW
3705 S KIMBARY WAY
SALT LAKE CITY, UT 84109-4024
Phone number: 801-654-0862