Individual
ANASTASIA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13135 W 21ST ST, WADSWORTH, IL 60083-9319
(847) 731-3192
(847) 731-3194
Mailing address
4014 GREGORY DR, ZION, IL 60099-1342
(708) 307-9631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.007968
IL
Other
Enumeration date
10/21/2017
Last updated
10/21/2017
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