Individual
DANIELLE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, MSSA
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2709
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006012A
IN
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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