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Individual
MICHELLE PETERSON
Active
Individual
MICHELLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
98823
CA
104100000X
Social Worker
98823
CA
1041C0700X
Clinical Social Worker
Primary
119345
CA
1041C0700X
Clinical Social Worker
98823
CA
Other
Enumeration date
12/15/2021
Last updated
11/29/2023
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