Individual
KALENA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD., LP
Contact information
Practice address
150 S WACKER DR STE 2400, CHICAGO, IL 60606-4211
(773) 960-6411
Mailing address
4519 S CALUMET AVE APT 1B, CHICAGO, IL 60653-4019
(773) 960-6411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010317
IL
Other
Enumeration date
08/08/2020
Last updated
08/08/2020
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