Individual
DENISE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIAC
Contact information
Practice address
1111 S STAPLEY DR, MESA, AZ 85204-5059
(602) 685-6000
(480) 834-5703
Mailing address
3003 N CENTRAL AVE STE 400, PHOENIX, AZ 85012-2929
(602) 685-6000
(602) 302-7925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LIAC-155342
AZ
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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