Individual
LORI D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 W 64TH ST STE 109, OVERLAND PARK, KS 66202-4175
(913) 534-4733
(913) 229-7511
Mailing address
6811 SHAWNEE MISSION PKWY, SUITE 310, OVERLAND PARK, KS 66202-4031
(913) 544-9285
(913) 229-7511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4120
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200730810B
—
KS
Enumeration date
01/28/2011
Last updated
06/13/2024
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