Individual
MRS. TARA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
5667 S REDWOOD RD UNIT 6B, TAYLORSVILLE, UT 84123-5495
(801) 712-2666
(801) 905-1161
Mailing address
5667 S REDWOOD RD UNIT 6B, TAYLORSVILLE, UT 84123-5495
(801) 712-2666
(801) 905-1161
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
UT
Other
Enumeration date
02/09/2014
Last updated
02/09/2014
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