Individual
DENISE ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LCMHC-VT
Contact information
Practice address
495 FAIRVIEW ST, BENNINGTON, VT 05201-9202
(512) 922-1188
Mailing address
495 FAIRVIEW ST, BENNINGTON, VT 05201-9202
(513) 922-1188
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0134137
VT
101YM0800X
Mental Health Counselor
15173
TX
Other
Enumeration date
09/13/2007
Last updated
10/08/2020
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