Individual
RAY ALBERT PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
1095 N TAFFETA DR, SALT LAKE CITY, UT 84116-1740
(385) 743-2444
Mailing address
1095 N TAFFETA DR, SALT LAKE CITY, UT 84116-1740
(385) 743-2444
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14207610-6009
UT
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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