| Doctor Name: | REGINA PETERSON |
| NPI Number: | 1003063694 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1601 23rd Ave S 3rd Floor Nashville, TN - 372123133 |
| Business Phone Number: | 6153277009 |
| Business Fax Number: | 6153434595 |
| Mailing Address: | 1601 23rd Ave S, 3rd Floor NASHVILLE |
| State: | TN |
| Postal Code: | 372123133 |
| Phone Number: | 6153277009 |
| Fax Number: | 6153434595 |
| NPI Enumeration Date: | 08/26/2008 |
| NPI Last Update Date: | 08/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |