Individual
MS. ANN RENEE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.C., N.C.C.
Contact information
Practice address
4686 CORRALES RD, CORRALES, NM 87048-8610
(505) 400-9913
(505) 890-1527
Mailing address
PO BOX 3237, CORRALES, NM 87048-3237
(505) 400-9913
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0119911
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201-047-937
PRESBYTERIAN HEALTH PLANS
NM
05
—
33007829
—
NM
Enumeration date
09/01/2006
Last updated
01/21/2025
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