Shirley Marie Petersen LCSW LMHP LADC

NPI 1740356336 - Counselor - 101YA0400X

NPI Details
NPI 1740356336
Gender Female
Enumeration Date 11/27/2006
Last Updated 06/25/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
HIGHWAY 18
PINE RIDGE HOSPITAL
PINE RIDGE SD, 57770, US
Phone (605) 867-3100
Fax (605) 867-3274
Business Location
917 N SPRUCE ST
GORDON NE, 69343-1116, US
Phone (308) 282-0180
Fax
Toxanomy
Taxonomy Code 101YA0400X
License State Nebraska
License Number P386
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According to our database, Shirley Marie Petersen LCSW LMHP LADC NPI is 1740356336, taxonomy code is 101YA0400X and license number is P386, license state is located at Nebraska. Shirley Marie Petersen LCSW LMHP LADC physically located at Highway 18, Pine Ridge SD, 57770. NPI Number Shirley Marie Petersen LCSW LMHP LADC has the Individual type.

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1740356336 NPI number is provided on an as is basis without warranty of any kind. 1740356336 is maintained by the National Plan & Provider Enumeration System. The contents of Shirley Marie Petersen LCSW LMHP LADC are for informational purposes only.