Individual
AMANDA RUTH PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2200 4TH ST, BAKER CITY, OR 97814-2615
(541) 523-3646
Mailing address
42266 ROUEN RD, BAKER CITY, OR 97814-8103
(541) 523-3646
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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