Provider Demographics
NPI:1720224652
Name:PETERSON, CLAUDIA
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2021
Mailing Address - Country:US
Mailing Address - Phone:928-443-5883
Mailing Address - Fax:928-778-1252
Practice Address - Street 1:26805 N CHOLLA
Practice Address - Street 2:
Practice Address - City:MEADVIEW
Practice Address - State:AZ
Practice Address - Zip Code:86444
Practice Address - Country:US
Practice Address - Phone:928-564-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health