Individual
LILY ELIZABETH PETERSON-WILLIBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2603 NORTHRIDGE PKWY STE 102, AMES, IA 50010-4046
(515) 827-7629
Mailing address
2603 NORTHRIDGE PKWY STE 102, AMES, IA 50010-4046
(515) 827-7629
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
074543
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058230
—
IA
Enumeration date
07/07/2011
Last updated
03/29/2024
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