Individual
JERRY B. PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1734 E 63RD ST, SUITE 301, KANSAS CITY, MO 64110-3543
(816) 333-9999
(816) 333-1943
Mailing address
1734 E 63RD ST, SUITE 301, KANSAS CITY, MO 64110-3543
(816) 333-9999
(816) 333-1943
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
002286
MO
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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