Individual
CORBY J PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
13135 OLD GLENN HWY, EAGLE RIVER, AK 99577-7562
(907) 632-3403
Mailing address
PO BOX 770925, EAGLE RIVER, AK 99577-0925
(907) 632-3403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
499
AK
Other
Enumeration date
05/16/2006
Last updated
02/09/2010
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