Individual
LISA P PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 WASHINGTON AVE, CLEVELAND, OH 44113-2333
(216) 226-2436
Mailing address
1619 WOODWARD AVE, LAKEWOOD, OH 44107-3635
(216) 226-2436
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.003962
OH
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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