Individual
REBECCA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1409 CLARK ST, DES MOINES, IA 50314-1964
(515) 643-6548
Mailing address
1409 CLARK ST, DES MOINES, IA 50314-1964
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001347
IA
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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