MR. Wayne Douglas Peterson, LPC

NPI #1124160262 in Richfield, Utah

Provider Information

NPI Number: 1124160262
Entity Type: Individual
Name: MR. Wayne Douglas Peterson, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Feb 13, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 164 N MAIN ST
Address 2: (REAR)
City: Richfield
State: Utah
ZIP Code: 84701-2170
Phone: (435) 201-4481

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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