Provider Information for 1982264263
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CHERYL L PETERSON LPCC
Sex: Female
NPI: 1982264263
Last Updated: 2023-02-04
Certification Date: 2023-02-04
Certification Date: 2023-02-04
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982264263 | ||||||||||||
| Enumeration Date | 2019-06-18 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1713 MARION WALDO RD MARION, OH 43302-7427 United States Phone: 740-387-2027 | Fax:740-382-8022 | ||||||||||||
| Primary Practice Address | 1713 MARION WALDO RD MARION, OH 43302-7427 United States Phone: 740-387-2027 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 615 SUNBURY RD | ||||||||||||
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