Individual
ANDREA LYNN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.A.T.C.
Contact information
Practice address
720 WOOD ST, EUREKA, CA 95501-4413
(707) 268-2990
Mailing address
1790 OAKDALE DR, MCKINLEYVILLE, CA 95519-7125
(707) 839-2987
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
040962
CA
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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