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Individual

MISS TERRESHA Y PETEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2444 W BLOCH RD, PHOENIX, AZ 85041-2930
(779) 248-1040
Mailing address
4915 W LYNNE LN, LAVEEN, AZ 85339-4240
(779) 248-1040

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
01/30/2021
Last updated
01/30/2021
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