Individual
KYLE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
415 N MAIN ST STE 101, CEDAR CITY, UT 84721-6158
(701) 852-3328
(651) 925-0057
Mailing address
415 N MAIN ST STE 101, CEDAR CITY, UT 84721-6158
(435) 250-4367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11390362-6004
UT
Other
Enumeration date
10/12/2018
Last updated
03/31/2023
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