Individual
EDYTHE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1306 11TH AVE, GREELEY, CO 80631-3835
(970) 347-2365
Mailing address
3342 KEENLAND WAY, WELLINGTON, CO 80549-3212
(970) 420-1242
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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