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Individual

MR. DARRYL WAYNE PETERSON II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3040 WICKER ST NE, CANTON, OH 44721-2298
(234) 521-1318
Mailing address
2605 BROAD AVE NW, CANTON, OH 44708-2400

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/05/2019
Last updated
06/28/2023
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