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1306187117
DIANE PETERSEN
GRAYSLAKE, IL
NPI
1306187117
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.005019)
Enumeration Date
2013-03-05
Last Update Date
2013-03-05
Business Address
-- DIANE PETERSEN LCSW
18640 W IL ROUTE 120
GRAYSLAKE, IL 60030-9733
Phone number: 847-548-6000
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Mailing Address
-- DIANE PETERSEN LCSW
18640 W IL ROUTE 120
GRAYSLAKE, IL 60030-9733
Phone number: 847-548-6000
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