Individual
JACQUELINE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.E.
Contact information
Practice address
1830 DESTINY LN, SUITE 107, BOWLING GREEN, KY 42104-1087
(270) 846-3222
(270) 846-3228
Mailing address
1830 DESTINY LN, SUITE 107, BOWLING GREEN, KY 42104-1087
(270) 846-3222
(270) 846-3228
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
05-0006
KY
Other
Enumeration date
06/06/2007
Last updated
06/23/2014
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