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1912464546
RUSSELL EDWARD PETERS
SANDY, UT
NPI
1912464546
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA MC60655977)
Enumeration Date
2019-03-01
Last Update Date
2019-03-01
Business Address
RUSSELL EDWARD PETERS
10708 S 1300 E STE 103
SANDY, UT 84094-5027
Phone number: 801-557-0674
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Mailing Address
RUSSELL EDWARD PETERS
10708 S 1300 E STE 103
SANDY, UT 84094-5027
Phone number: 801-557-0674
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