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Individual

DAVID JORDAN PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LAC

Contact information

Practice address
109 N 48TH ST, SPRINGDALE, AR 72762-3743
(479) 222-0269
Mailing address
5900 W STONEY BROOK RD APT 9106, ROGERS, AR 72758-4649
(903) 571-8955

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2304006
AR

Other

Enumeration date
06/22/2023
Last updated
06/22/2023
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