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1255797890
SUSAN PETERSON
PROVO, UT
NPI
1255797890
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: UT 5476575-6004)
Enumeration Date
2016-01-12
Last Update Date
2016-01-12
Business Address
-- SUSAN PETERSON CMHC
4501 N UNIVERSITY AVE
PROVO, UT 84604-5504
Phone number: 801-227-2057
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Mailing Address
-- SUSAN PETERSON CMHC
4501 N UNIVERSITY AVE
PROVO, UT 84604-5504
Phone number: 801-227-2057
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