NPI 1225089840

Corby J Petersen, LCSW

Practitioner Clinical Social Worker Eagle River, AK

Practice location

Address: 13135 Old Glenn Hwy, Eagle River, AK 99577-7562
Phone: (907) 632-3403
Mailing address: PO Box 770925, Eagle River, AK 99577-0925

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 499 (AK)

Other Social Worker providers in Alaska →

Registry record

NPI: 1225089840
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 May 2006
Record last updated: 9 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.