Individual
KACEY M PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC
Contact information
Practice address
320 NE 3RD ST, STUART, IA 50250-2157
(641) 247-8114
Mailing address
301 E GRANT ST, CASEY, IA 50048-1011
(641) 247-8114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001334
IA
Other
Enumeration date
09/20/2010
Last updated
09/08/2015
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