Individual
CORIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
14900 BOGLE DR STE 200, CHANTILLY, VA 20151-1757
(703) 817-9890
Mailing address
14900 BOGLE DR STE 200, CHANTILLY, VA 20151-1757
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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