Individual
GWENDOLYN JEAN PETERSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
3649 SW BURLINGAME RD, TOPEKA, KS 66611-2051
(785) 266-6751
(785) 266-4533
Mailing address
3649 SW BURLINGAME RD, TOPEKA, KS 66611-2051
(785) 266-6751
(785) 266-4533
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2390
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00183371
RAILROAD MEDICARE
KS
Enumeration date
02/09/2006
Last updated
07/08/2007
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