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Individual
SALLY ANN PETERSON
Active
Individual
SALLY ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1768
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15665
HEALTH PARTNERS
—
05
—
42626000
—
WI
01
—
4607091
MEDICA
—
01
—
641671046996
PREFERRED ONE
—
01
—
7038035
AETNA
—
01
—
98G68PE
MN BCBS
MN
Enumeration date
09/16/2006
Last updated
07/09/2007
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