Individual
MRS. DIANE J. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3325 N UNIVERSITY AVE, SUITE 300, PROVO, UT 84604-4465
(801) 226-3008
Mailing address
241 E 4200 N, PROVO, UT 84604-5010
(801) 226-3424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
97-323498-3902
UT
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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