Kayli Peterson, LPC STUDENT INTERN

NPI #1144871096 in Dallas, Oregon

Provider Information

NPI Number: 1144871096
Entity Type: Individual
Name: Kayli Peterson, LPC STUDENT INTERN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LPC STUDENT INTERN
Enumeration Date: Sep 23, 2019
Last Updated: Nov 7, 2019

Practice Location

Address: 182 SW ACADEMY ST
City: Dallas
State: Oregon
ZIP Code: 97338-1996
Phone: (503) 623-9289

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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