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General NPI Number Information
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NPI Number | 1174778252
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Entity Type | Individual
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Provider Name | MONIKA SANDBERG PETERSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 3336 E. CHANDLER HEIGHTS RD #123
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City | GILBERT
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State | AZ
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Zip | 85298
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Country | US
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Telephone | 480-570-9034
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Fax | 505-884-5701
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Provider Business Mailing Address
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Address Line | 3336 E. CHANDLER HEIGHTS RD #123
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City | GILBERT
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State | AZ
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Zip | 85298
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Country | US
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Telephone | 480-570-9034
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Fax | 505-884-5701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0121881
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1093
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4577
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License Number State | AZ
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