Individual
ANNA GRACE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CG 61390999
Contact information
Practice address
201 HIGHLAND DR, BUENA, WA 98921-0139
(509) 865-6705
Mailing address
311 S 4TH ST, SELAH, WA 98942-1667
(406) 249-6556
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG61390999
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0755984
—
WA
Enumeration date
02/15/2023
Last updated
02/15/2023
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