Individual
LAQUISTA L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2712 MIDDLEBURG DR, SUITE 207B, COLUMBIA, SC 29204-2415
(803) 667-8773
Mailing address
2712 MIDDLEBURG DR, SUITE 207B, COLUMBIA, SC 29204-2415
(803) 667-8773
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5306
SC
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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