Individual
MR. A PERRIN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACSW, LCSW
Contact information
Practice address
27192 SAN MARINO DR, PUNTA GORDA, FL 33983-3127
(941) 626-8363
Mailing address
27192 SAN MARINO DR, PUNTA GORDA, FL 33983-3127
(941) 626-8363
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW002292
GA
1041C0700X
Clinical Social Worker
LC9524
ME
1041C0700X
Clinical Social Worker
Primary
SW7101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412090099
—
ME
01
—
Z034M
BCBS
FL
Enumeration date
07/17/2006
Last updated
01/06/2015
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