Stacy Peterson

NPI #1942460563 in Skokie, Illinois

Provider Information

NPI Number: 1942460563
Entity Type: Individual
Name: Stacy Peterson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Jun 17, 2008
Last Updated: Jun 17, 2008

Practice Location

Address: 8615 CRAWFORD AVE
City: Skokie
State: Illinois
ZIP Code: 60076-2125
Phone: (630) 776-1936

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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