Organization
LEOLA PETERSON, LCSW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEOLA PETERSON LCSW (PRESIDENT)
(719) 339-8010
Entity
Organization
Contact information
Practice address
10 BOULDER CRESCENT ST, COLORADO SPRINGS, CO 80903-3344
(719) 339-8010
(719) 344-5080
Mailing address
95 W BOULDER ST, COLORADO SPRINGS, CO 80903-3371
(719) 339-8010
(719) 344-5080
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CO106
CO
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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