Peterson, Tandice

Peterson, Tandice is an sole proprietor health care provider with primary practice located at 1777 E Clark St Ste 210 , Pocatello ID 83201-3357. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Peterson, Tandice can be contacted via phone (208) 427-5891.

Contact Information

Primary practice address
1777 E Clark St Ste 210 Pocatello ID 83201-3357
Phone: (208) 427-5891
Fax: (208) 427-5895
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LCPC-7004 Idaho
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1104199074
LBN Legal business name Peterson, Tandice
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2012
Last updated Jul 11th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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