Individual
MELISSA ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
16614 W 159TH ST STE 302, LOCKPORT, IL 60441-8009
(708) 341-1452
Mailing address
16627 DORCHESTER PL, LOCKPORT, IL 60441-6010
(708) 421-0975
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.109431
IL
1041S0200X
School Social Worker
319534
IL
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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