Individual provider · Type 1 NPI

Kayli Peterson, LPC STUDENT INTERN

Mental Health Counselor · Dallas, OR

NPI number 1144871096 Active

Practice location

182 SW Academy St
Dallas, OR 97338-1996

Call (503) 623-9289 Map

Mailing address

11445 SW Paulina Dr
Wilsonville, OR 97070-8549

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1144871096

Kayli Peterson, LPC STUDENT INTERN's National Provider Identifier is 1144871096, issued on Sep 23, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dallas, OR. The record was last updated on Nov 7, 2019.