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General NPI Number Information
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NPI Number | 1518685684
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Entity Type | Individual
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Provider Name | TERASA LYNN PETERSON
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Gender | Female
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Dates
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Enumeration Date | 08/16/2022
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 245 E 680 S
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City | CEDAR CITY
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State | UT
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Zip | 84720-3593
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Country | US
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Telephone | 435-867-7654
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Fax | 435-634-8700
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Provider Business Mailing Address
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Address Line | 474 W 200 N # 300
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City | ST GEORGE
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State | UT
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Zip | 84770-4505
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Country | US
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Telephone | 435-634-5600
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Fax | 435-634-8700
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13552628-3501
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License Number State | UT
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