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1255791596
CONNIE PETERSEN
MERIDIAN, ID
NPI
1255791596
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC - 6095)
Enumeration Date
2016-02-29
Last Update Date
2016-02-29
Business Address
-- CONNIE PETERSEN LPC
2584 N STOKESBERRY PL
MERIDIAN, ID 83646-1144
Phone number: 208-631-9008
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Mailing Address
-- CONNIE PETERSEN LPC
7082 N PENNCROSS WAY
MERIDIAN, ID 83646-5185
Phone number: 208-631-9008
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