Individual
MRS. KATHRYN LOUISE PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
115 E BIRCH AVE, FLAGSTAFF, AZ 86001-4609
(928) 213-0068
(928) 774-4367
Mailing address
115 E BIRCH AVE, FLAGSTAFF, AZ 86001-4609
(928) 213-0068
(928) 774-4367
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-4048
AZ
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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