Individual
SAMANTHA JO PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
1095 MIDWAY RD, MENASHA, WI 54952-1115
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
135619-121
WI
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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