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General NPI Number Information
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NPI Number | 1447487772
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Entity Type | Individual
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Provider Name | EMILY CARTER PETERSEN MA
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Gender | Female
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Dates
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Enumeration Date | 06/13/2009
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Last Update Date | 06/13/2009
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Provider Practice Location Address
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Address Line | 8806 NC HIGHWAY 87
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City | REIDSVILLE
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State | NC
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Zip | 27320-7363
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Country | US
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Telephone | 336-634-3250
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 FRANCES DR
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City | REIDSVILLE
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State | NC
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Zip | 27320-7012
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Country | US
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Telephone | 336-342-4297
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2001
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License Number State | NC
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