| NPI | 1235478157 |
|---|---|
| Former Name | GHELSEA N PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 9585529-3502) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2018-04-24 |