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Individual

MR. AUSTIN PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1255 KENDALL RD, SAN LUIS OBISPO, CA 93401-8750
(805) 781-3535
Mailing address
6088 MARSHALL WAY, SAN LUIS OBISPO, CA 93401-8264
(805) 602-6587

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/02/2020
Last updated
01/02/2020
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