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Individual

MS. REKETTA PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3875 GEIST RD STE E190, FAIRBANKS, AK 99709-3564
(844) 942-2434
Mailing address
1423 PEGER RD, FAIRBANKS, AK 99709-5169
(907) 971-1300

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
164379
AK
101YP2500X
Professional Counselor
Primary
APC006265
GA

Other

Enumeration date
03/12/2018
Last updated
09/10/2020
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