Individual
MS. SHOTUNUS DENEAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W
Contact information
Practice address
108 N MAIN ST, SUITE 305, SOUTH BEND, IN 46601-1625
(574) 234-3515
(574) 234-3565
Mailing address
108 N MAIN ST, SUITE 305, SOUTH BEND, IN 46601-1625
(574) 234-3515
(574) 234-3565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW
IN
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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