Most Relevant Information
Provider Data
| NPI Number: | 1003469859 |
| Provider Name: | JAIMIE M PETERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 149020204 |
Most Important Dates
| Enumeration Date: | 07/22/2019 |
| Last Updated: | 07/22/2019 |
Provider Practice Location
2265 W ALTORFER DR
PEORIA
IL
616151807
Practice Location Phone/Fax
| Phone: | 3096837700 |
| Fax: | 3096837752 |
Provider Mailing Location
2265 W ALTORFER DR
PEORIA
IL
616151807
Provider Mailing Phone/Fax
| Phone: | 3096837700 |
| Fax: | 3096837752 |