Individual
MACY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
338 W 300 N, HYDE PARK, UT 84318-4044
(435) 200-5208
Mailing address
9080 N 5200 W, ELWOOD, UT 84337-8640
(435) 200-5208
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13023209-6009
UT
Other
Enumeration date
09/14/2022
Last updated
05/14/2025
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