Individual
ANGELICA DARLYNETTA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
58205 BAYOU JACOB RD, PLAQUEMINE, LA 70764
(225) 428-1411
Mailing address
58205 BAYOU JACOB RD, PLAQUEMINE, LA 70764-5237
(225) 421-0223
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5602
LA
171M00000X
Case Manager/Care Coordinator
5602
LA
Other
Enumeration date
03/05/2018
Last updated
05/16/2022
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