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ANASTASIA PETERSON

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1295246841

Individual Registrant:
 ANASTASIA  PETERSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
13135 W 21ST ST  WADSWORTH, IL 60083-9319 US
Tel: 847-731-3192  Fax: 847-731-3194

Contact information for business:
4014 GREGORY DR  ZION, IL 60099-1342 US
Tel: 708-307-9631  Fax: --

Registration Information:
NPI: 1295246841
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
IL178.007968

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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