Individual
COSHA ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LPC
Contact information
Practice address
1000 W NIFONG BLVD BLDG 6, COLUMBIA, MO 65203-5615
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2019045184
MO
103T00000X
Psychologist
Primary
2020030435
MO
Other
Enumeration date
04/20/2010
Last updated
12/16/2020
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