Individual
LACEY K PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362
(307) 637-6852
Mailing address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 632-9362
(307) 637-6852
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW-1942
CO
1041C0700X
Clinical Social Worker
Primary
LCSW-1046
WY
Other
Enumeration date
03/20/2012
Last updated
09/01/2017
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