Individual
MR. WAYNE LAWRENCE PETERSEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
13 OTSEGO DR, NEWPORT NEWS, VA 23602-2068
(757) 513-9926
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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