Individual
MRS. TANYA LYNN PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, SAC-IT
Contact information
Practice address
9224 W BURLEIGH ST, MILWAUKEE, WI 53222-3503
(414) 367-9869
Mailing address
N53W27805 BANTRY RD, SUSSEX, WI 53089-4535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18534-130
WI
101YM0800X
Mental Health Counselor
Primary
7314-125
WI
Other
Enumeration date
10/02/2018
Last updated
12/03/2019
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