Individual
PETER B QUALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCSW, LCAC, LMFT
Contact information
Practice address
6552 LANA CT E, NEW PALESTINE, IN 46163-9777
(317) 440-8380
Mailing address
6552 LANA CT E, NEW PALESTINE, IN 46163-9777
(131) 744-0838
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002808A
IN
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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