Individual
CAROLINE CROUCH PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-BC, LPC
Contact information
Practice address
530 CARPENTER LN, PHILADELPHIA, PA 19119-3401
(215) 528-2138
Mailing address
530 CARPENTER LN, PHILADELPHIA, PA 19119-3401
(215) 528-2138
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC004590
PA
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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