Individual
DANIELLE KARIN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1726 S BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
(801) 375-9225
Mailing address
1726 S BUCKLEY LN, PROVO, UT 84606-5031
(801) 373-6562
(801) 375-9225
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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