Individual
HEIDI PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1747 HERITAGE LN STE B101, SYRACUSE, UT 84075-8546
(385) 439-1926
Mailing address
1747 HERITAGE LN STE B101, SYRACUSE, UT 84075-8546
(385) 439-1926
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11782403-3502
UT
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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