Provider Information for 1922252188
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PAULA MARIE PETERSON LPC
Other Names:Former Name:PAULA MARIE SIPPY BSSex: Female
NPI: 1922252188
Last Updated: 2010-09-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1922252188 | ||||||||||||
| Enumeration Date | 2008-11-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 505 S DEWEY ST SUITE 208 EAU CLAIRE, WI 54701-3704 United States Phone: 715-832-1678 | Fax:715-832-6680 | ||||||||||||
| Primary Practice Address | 505 S DEWEY ST SUITE 208 EAU CLAIRE, WI 54701-3704 United States Phone: 715-832-1678 | Fax:715-832-6680 | ||||||||||||
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