Provider Demographics
NPI:1154456515
Name:PETERSON, VALERIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MARKET ST
Mailing Address - Street 2:BRIDGEWELL 2ND FLOOR
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1805
Mailing Address - Country:US
Mailing Address - Phone:978-459-0389
Mailing Address - Fax:978-459-7642
Practice Address - Street 1:35 MARKET ST
Practice Address - Street 2:BRIDGEWELL 2ND FLOOR
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1805
Practice Address - Country:US
Practice Address - Phone:978-459-0389
Practice Address - Fax:978-459-7642
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health