Individual
NANCY NICOLE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-MH
Contact information
Practice address
1369 MONTGOMERY ST, CUSTER, SD 57730-8246
(605) 673-3832
Mailing address
PO BOX 83, CUSTER, SD 57730-0083
(605) 673-3832
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-MH30524
SD
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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