Individual
JANE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1828 S YUMA ST, SALT LAKE CITY, UT 84108-2927
(801) 631-8478
Mailing address
1828 S YUMA ST, SALT LAKE CITY, UT 84108-2927
(801) 631-8478
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
139589-3501
UT
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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