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Individual

MRS. JESSICA PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
5228 CYPRESS CT, SHELBYVILLE, KY 40065-7764
(502) 640-9094
(502) 647-2469
Mailing address
5228 CYPRESS CT, SHELBYVILLE, KY 40065-7764
(502) 640-9094
(502) 647-2469

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3739
KY

Other

Enumeration date
11/04/2013
Last updated
11/04/2013
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