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Individual
MS. JENNIFER MARIE PETERSON
Active
Individual
MS. JENNIFER MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
113398
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2284745
MA
390200000X
Student in an Organized Health Care Education/Training Program
2284745
MA
Other
Enumeration date
09/28/2006
Last updated
09/03/2014
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