person
Mrs. Tandice Peterson
Mental Health Counselor in Pocatello, Idaho
NPI 1104199074

Tandice Peterson is a Mental Health Counselor based in Pocatello, ID and is specialized in Mental Health. Tandice Peterson practices in Pocatello, ID. The NPI Number for Tandice Peterson is 1104199074 and holds a License No. LCPC-7004 (Idaho).

The current practice location address for Tandice Peterson is 1777 E Clark St Ste 210, Pocatello, ID and can be reached out via phone at 208-427-5891 and via fax at 208-427-5895.

Location: 1777 E Clark St Ste 210, Pocatello, ID, 83201-3357
person
Provider Profile Details
NPI Number
1104199074
Provider Name
Tandice Peterson
Credential
Provider Entity Type
Individual
Gender
Female
Address
1777 E Clark St Ste 210, Pocatello, ID, 83201-3357
Phone Number
208-427-5891
Fax Number
208-427-5895
Provider Enumeration Date
02/22/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1777 E Clark St Ste 210
City
State
Zip
83201-3357
Phone Number
208-427-5891
Fax Number
208-427-5895
person
Provider Business Mailing Address Details
Address
1777 E Clark St Ste 210
City
State
Zip
83201-3357
Phone Number
208-427-5891
Fax Number
208-427-5895
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LCPC-7004 (Idaho)
Definition
Definition to come...
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