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General NPI Number Information
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NPI Number | 1962925578
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Entity Type | Individual
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Provider Name | TARYN JOY PETERSON LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 05/11/2025
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Provider Practice Location Address
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Address Line | 2055 N MOUNT JULIET RD STE 204
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City | MT JULIET
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State | TN
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Zip | 37122-4296
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Country | US
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Telephone | 615-492-9265
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Fax | 615-941-2334
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Provider Business Mailing Address
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Address Line | 2055 N MOUNT JULIET RD STE 204
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City | MT JULIET
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State | TN
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Zip | 37122-4296
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Country | US
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Telephone | 615-492-9265
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Fax | 615-941-2334
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1149
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License Number State | TN
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