Individual
DR. POLLY A PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1406 E FRANKLIN ST, BOISE, ID 83712-7404
(208) 331-1936
(208) 331-1937
Mailing address
1406 E FRANKLIN ST, BOISE, ID 83712-7404
(208) 331-1936
(208) 331-1937
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COUN-50
ID
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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