Individual
JACCI PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMAP
Contact information
Practice address
114 BRISTLECONE DR, FORT COLLINS, CO 80524-2031
(970) 494-4200
Mailing address
4856 INNOVATION DR STE B, FORT COLLINS, CO 80525-5540
(970) 494-4200
(844) 270-1824
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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