Individual
SHAWNTE LATRYCE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MPH, CHES
Contact information
Practice address
4300 PORTSMOUTH BLVD STE 262, CHESAPEAKE, VA 23321-2138
(757) 956-5742
Mailing address
4247 WHITE CAP CRST, CHESAPEAKE, VA 23321-3256
(678) 702-7290
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
173C00000X
Reflexologist
—
—
174H00000X
Health Educator
—
—
225700000X
Massage Therapist
Primary
0019011750
VA
251K00000X
Public Health or Welfare Agency
—
—
Other
Enumeration date
11/14/2019
Last updated
04/10/2023
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