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Individual
ANNIE PETERSEN
Active
Individual
ANNIE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0137348
VT
101YP2500X
Professional Counselor
097.0135864
VT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
097.0135864
VT
Other
Enumeration date
11/28/2023
Last updated
09/23/2026
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