Individual
MR. CLIFTON KENT PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
9192 S 300 W, SUITE 19, SANDY, UT 84070-2671
(801) 949-1199
Mailing address
9192 S 300 W, SUITE 19, SANDY, UT 84070-2671
(801) 949-1199
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
123917-3501
UT
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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