Individual
EMILY PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 542-1026
Mailing address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 542-1026
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
WY
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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