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Individual
MS. LACEY JEAN PETERSON
Active
Individual
MS. LACEY JEAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11115847-3501
UT
1041C0700X
Clinical Social Worker
CSW.09926230
CO
Other
Enumeration date
06/26/2017
Last updated
02/08/2021
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