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Individual

MS. ANNA LOUISE PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.D, LCPC

Contact information

Practice address
129 WEST KENT, MISSOULA, MT 59801
(406) 531-0659
Mailing address
402 EAST BECKWITH AVE., MISSOULA, MT 59801
(406) 531-0659

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
980
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
253691
MT
Enumeration date
08/31/2006
Last updated
07/01/2016
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