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Organization
WISDOM TREE COUNSELING
Active
Organization
WISDOM TREE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERALEEN M PETERSON LCSW (OWNER)
(909) 291-9349
Entity
Organization
Contact information
Practice address
10601 CIVIC CENTER DR, SUITE 100-M, RANCHO CUCAMONGA, CA 91730-3878
(909) 291-9349
Mailing address
10601 CIVIC CENTER DR, RANCHO CUCAMONGA, CA 91730-3878
(909) 291-9349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS28561
CA
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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