Individual
DIANE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2020 TALLEY RD, LEESBURG, FL 34748-3426
(352) 315-7800
(352) 360-6582
Mailing address
204 WESTWOOD DR, LEESBURG, FL 34748-8753
(352) 315-7800
(352) 360-6582
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MH 9521
FL
Other
Enumeration date
07/08/2009
Last updated
03/19/2020
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