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Individual
MICHELE LEE PETERSON
Active
Individual
MICHELE LEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
309873-3501
UT
1041C0700X
Clinical Social Worker
73177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000252015
HMSA, QUEST, AND TRI-CARE
HI
01
—
281460238
UNITED BEHAVIORAL HEALTH
HI
Enumeration date
08/27/2005
Last updated
01/17/2025
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