LUCAS CEDRIC PETERSEN

BOISE, ID
NPI1710869557
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  8911017)
Enumeration Date2025-07-23
Last Update Date2025-07-23
Business Address
LUCAS CEDRIC PETERSEN
6177 N OLIVER AVE
BOISE, ID 83714-2070
Phone number: 208-954-2310
Mailing Address
LUCAS CEDRIC PETERSEN
6177 N OLIVER AVE
BOISE, ID 83714-2070
Phone number: 208-954-2310
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