Individual
AMIE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LPCC, LMHC
Contact information
Practice address
907 SHASTA DR, WALLA WALLA, WA 99362-1537
(509) 713-2150
Mailing address
907 SHASTA DR, WALLA WALLA, WA 99362-1537
(509) 713-2150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1667
ND
101YM0800X
Mental Health Counselor
Primary
61348595
WA
101YM0800X
Mental Health Counselor
847-8-1-15-304
ND
101YM0800X
Mental Health Counselor
CC01565
MN
Other
Enumeration date
01/10/2012
Last updated
12/11/2022
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