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Individual

MRS. CARY LEIGH PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
4420 76TH ST NE, MARYSVILLE, WA 98270-3726
(425) 651-7490
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH 60124112
WA
104100000X
Social Worker
Primary
LW60750069
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2046876
WA
Enumeration date
09/24/2009
Last updated
09/14/2017
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