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Individual
JOHNATHON DAHLIN PETERSON
Active
Individual
JOHNATHON DAHLIN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11125479-6004
UT
101YP2500X
Professional Counselor
95059
TX
Other
Enumeration date
08/04/2022
Last updated
09/25/2024
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