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Individual

MRS. DIANNE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OM

Contact information

Practice address
39 W BROAD ST STE D, COOKEVILLE, TN 38501-2573
(931) 510-8667
(931) 858-4490
Mailing address
39 WEST BROAD STREET SUITE D, COOKEVILLE, TN 38502
(931) 510-8667
(931) 858-4490

Taxonomy

Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary

Other

Enumeration date
03/09/2010
Last updated
03/09/2010
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