Individual
LAEL R PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1980 WILLAMETTE FALLS DR, SUITE 240, WEST LINN, OR 97068-4668
(503) 656-2888
(503) 656-2282
Mailing address
1980 WILLAMETTE FALLS DR, SUITE 240, WEST LINN, OR 97068-4668
(503) 656-2888
(503) 656-2282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3614
OR
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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