Individual
MS. FAYE RUTH PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LISW
Contact information
Practice address
4126 PATRICIA DR, URBANDALE, IA 50322-1303
(515) 360-7446
Mailing address
4126 PATRICIA DR, URBANDALE, IA 50322-1303
(515) 360-7446
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01054
IA
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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