Doctor Name: | MS. JUDITH R. PETERSON-WILLIAMS |
NPI Number: | 1538483136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 6401008240 |
Business Practice Address: | 4808 Derby Cir Berrien Springs, MI - 491038512 |
Business Phone Number: | 2698769986 |
Business Fax Number: | |
Mailing Address: | 4808 Derby Cir, BERRIEN SPRINGS |
State: | MI |
Postal Code: | 491038512 |
Phone Number: | 2698769986 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2010 |
NPI Last Update Date: | 03/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6401008240 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |