Individual
LORI B PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5100 N BROOKLINE AVE STE 210, OKLAHOMA CITY, OK 73112-3603
(405) 990-7560
Mailing address
6806 NW 44TH ST, BETHANY, OK 73008-2523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
U/S
OK
101YP2500X
Professional Counselor
Primary
6454
OK
Other
Enumeration date
09/24/2014
Last updated
12/19/2019
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