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1790161776
STEPHEN PETERSON
LAFAYETTE, IN
NPI
1790161776
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34001361A)
Enumeration Date
2015-07-31
Last Update Date
2015-07-31
Business Address
-- STEPHEN PETERSON LCSW,LCAC
3708 ASHLEY OAKS DR APT. D
LAFAYETTE, IN 47905-4495
Phone number: 765-586-5024
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Mailing Address
-- STEPHEN PETERSON LCSW,LCAC
3708 ASHLEY OAKS DR APT. D
LAFAYETTE, IN 47905-4495
Phone number: 765-586-5024
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