| NPI | 1235426529 |
|---|---|
| Former Name | LILY PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 074543) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2024-03-29 |