Individual
DELEA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR STE 4-420, FAIRFAX, VA 22031-4512
(703) 289-7560
(703) 204-9001
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012941
VA
1041C0700X
Clinical Social Worker
17946
FL
Other
Enumeration date
12/16/2020
Last updated
04/12/2022
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