| Doctor Name: | MISS GAY LYNN PETERSON |
| NPI Number: | 1023214038 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 323 W 6th St Okmulgee, OK - 744475019 |
| Business Phone Number: | 9187569250 |
| Business Fax Number: | |
| Mailing Address: | 1116 S Florida Ave, OKMULGEE |
| State: | OK |
| Postal Code: | 744476200 |
| Phone Number: | 9187564512 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2007 |
| NPI Last Update Date: | 03/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |