Individual
EDWARD CHASE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, MBA
Contact information
Practice address
27 W PRINCETON DR, MIDVALE, UT 84047-7513
(801) 809-7990
Mailing address
27 W PRINCETON DR, MIDVALE, UT 84047-7513
(801) 809-7990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8454347-3501
UT
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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