Individual
HOLLY SUE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9690 S 1300 E, SUITE 200, SANDY, UT 84094-3721
(801) 501-2025
(801) 501-4099
Mailing address
159 F ST, SALT LAKE CITY, UT 84103-2603
(801) 501-2025
(801) 501-4099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
342641-3501
UT
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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