| NPI | 1215802426 |
|---|---|
| Former Name | ERICA N PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17209) |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2026-02-10 |