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1851087589
MYRANDA PETERSON
SALT LAKE CITY, UT
NPI
1851087589
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 12247068-3501)
Enumeration Date
2023-04-14
Last Update Date
2023-04-14
Business Address
MYRANDA PETERSON LCSW
500 FOOTHILL DR
SALT LAKE CITY, UT 84148-0001
Phone number: 801-582-1565
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Mailing Address
MYRANDA PETERSON LCSW
7256 W AFTERGLOW LN
WEST VALLEY CITY, UT 84081-1204
Phone number: 801-244-8669
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