Individual
TAMARA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 WILLOW LAWN DR STE 304, RICHMOND, VA 23230-3423
(804) 381-4783
Mailing address
1601 WILLOW LAWN DR STE 304, RICHMOND, VA 23230-3423
(804) 381-4783
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701014879
VA
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30018359170001
—
VA
Enumeration date
05/17/2023
Last updated
02/05/2026
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