Individual
DANIELL SUE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1711 OSCEOLA AVE STE 115, CHARITON, IA 50049-1516
(641) 774-8484
Mailing address
302 NE 14TH ST, LEON, IA 50144-1206
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19000
IA
Other
Enumeration date
01/02/2019
Last updated
01/08/2019
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