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Individual

AMANTHA H. PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8136 OLD KEENE MILL RD, A-302, SPRINGFIELD, VA 22152-1850
(703) 913-8563
(703) 913-8565
Mailing address
8136 OLD KEENE MILL RD, A-302, SPRINGFIELD, VA 22152-1850
(703) 913-8563
(703) 913-8565

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008146
VA

Other

Enumeration date
05/12/2016
Last updated
05/12/2016
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