Individual
HOLLY PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1143 47TH AVE, LONG ISLAND CITY, NY 11101-5465
(631) 880-0644
Mailing address
3127 36TH ST, APT 1, ASTORIA, NY 11106-1001
(631) 880-0644
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
085016
NY
Other
Enumeration date
02/05/2014
Last updated
02/05/2014
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