Individual
MARIAH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2150 S 1300 E, SALT LAKE CITY, UT 84106-4333
(303) 909-0286
Mailing address
455 S 700 E UNIT 4213, SALT LAKE CITY, UT 84102-3884
(303) 909-0286
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10509741-3501
UT
1041C0700X
Clinical Social Worker
1478
CO
Other
Enumeration date
08/31/2009
Last updated
12/07/2022
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