| NPI | 1588901805 |
|---|---|
| Former Name | KATIE M PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5373-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 1080-226) |
| 101YM0800X Counselor, Mental Health (Licence: WI 5373-125) | |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2021-10-18 |