Most Relevant Information
Provider Data
| NPI Number: | 1003328527 |
| Provider Name: | ANN COOPER PETERSEN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 24986 |
Most Important Dates
| Enumeration Date: | 10/25/2017 |
| Last Updated: | 10/25/2017 |
Provider Practice Location
240 SPRUCE ST
GRIDLEY
CA
959482216
Practice Location Phone/Fax
| Phone: | 5308469000 |
| Fax: |
Provider Mailing Location
240 SPRUCE ST
GRIDLEY
CA
959482216
Provider Mailing Phone/Fax
| Phone: | 5308466000 |
| Fax: |