Individual
LE ANN M PETERSILIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1905 19TH ST, GREAT BEND, KS 67530-2502
(620) 792-5700
Mailing address
1905 19TH ST, GREAT BEND, KS 67530-2502
(620) 792-5700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11432
KS
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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