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1912391475
JACOB MICHAEL PETERSON
PARADISE, CA
NPI
1912391475
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2015-03-23
Last Update Date
2015-03-23
Business Address
-- JACOB MICHAEL PETERSON
7204 SKYWAY
PARADISE, CA 95969-3280
Phone number: 530-872-4128
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Mailing Address
-- JACOB MICHAEL PETERSON
7204 SKYWAY
PARADISE, CA 95969-3280
Phone number: 530-872-4128
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