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Individual

JOLYNDA PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2111 CHAMPA ST, DENVER, CO 80205-2529
(303) 293-2217
Mailing address
4141 E DICKENSON PL, DENVER, CO 80222-6012

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000799
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09927082
CO

Other

Enumeration date
04/10/2013
Last updated
02/11/2021
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