Individual
KIMBERLY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
118 ROBBINS ST, MOLALLA, OR 97038-8141
(971) 999-0175
(855) 651-0575
Mailing address
PO BOX 85, MOLALLA, OR 97038-0085
(971) 999-0175
(855) 651-0575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L8492
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500712083
—
OR
Enumeration date
07/15/2016
Last updated
05/17/2025
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