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Individual

JEANICE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LEP

Contact information

Practice address
41914 50TH ST W, LANCASTER, CA 93536-2963
(661) 722-0716
Mailing address
41914 50TH ST W, LANCASTER, CA 93536-2963
(661) 722-0716

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
3666
CA

Other

Enumeration date
09/11/2019
Last updated
09/11/2019
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