Organization Name: | DEBORAH PETERMAN COUNSELING |
NPI Number: | 1255567608 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH PETERMAN (OWNER/THERAPIST) |
Mailing Address: | 1488 E Green Bay St # 8 Shawano |
State: | WI US |
Postal Code: | 541662258 |
Phone Number: | 7155248896 |
Fax Number: | 7155248964 |
NPI Enumeration Date: | 05/29/2009 |
NPI Last Update Date: | 05/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1998-132 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |