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Individual

EIVIND PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X

Contact information

Practice address
4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
(480) 433-0804
Mailing address
4539 N 22ND ST STE R, PHOENIX, AZ 85016-4639
(480) 788-5114

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-20267
AZ

Other

Enumeration date
01/31/2026
Last updated
02/27/2026
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