Doctor Name: | SANDRA ANNE PETERSEN-TETZ |
NPI Number: | 1013108349 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC I |
License Number: | 98-04-29 |
Business Practice Address: | 185 N 4th St Saint Helens, OR - 970511535 |
Business Phone Number: | 5033664540 |
Business Fax Number: | 5033664526 |
Mailing Address: | 185 N 4th St, SAINT HELENS |
State: | OR |
Postal Code: | 970511535 |
Phone Number: | 5033664540 |
Fax Number: | 5033664526 |
NPI Enumeration Date: | 08/01/2007 |
NPI Last Update Date: | 08/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 98-04-29 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |