| Doctor Name: | MS. CHERYL ANNE PETOSA |
| NPI Number: | 1386828465 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MED,CMHS |
| License Number: | RC00028549 |
| Business Practice Address: | 105 N.w. 1st St. Coupeville, WA - 982390160 |
| Business Phone Number: | 3606785555 |
| Business Fax Number: | 3606783636 |
| Mailing Address: | Po Box 160, COUPEVILLE |
| State: | WA |
| Postal Code: | 982390160 |
| Phone Number: | 3606785555 |
| Fax Number: | 3606783636 |
| NPI Enumeration Date: | 12/24/2007 |
| NPI Last Update Date: | 12/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | RC00028549 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |