NPI | 1952692071 |
---|---|
Former Name | MEGAN PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-17803) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2010040962) |
Enumeration Date | 2011-04-23 |
Last Update Date | 2020-08-13 |