Individual
DANIELLE E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC, LPC
Contact information
Practice address
429 W BROADWAY AVE, MEDFORD, WI 54451-1608
(715) 748-4312
Mailing address
850 E BROADWAY AVE APT A, MEDFORD, WI 54451-1586
(715) 965-1201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16281-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
17253-130
WI
101YP2500X
Professional Counselor
Primary
3198-226
WI
101YP2500X
Professional Counselor
7067-125
WI
Other
Enumeration date
12/05/2016
Last updated
07/17/2024
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