Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mary Alice Petersen, MA, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1063661916

Mrs. Mary Alice Petersen, MA, CCC-SLP is a Speech-Language Pathologist in Newcastle, Wyoming. Practices as a sole proprietor. Licensed in Wyoming.

Licensed in
WY
In the registry since
2008
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

104 Stampede St
Newcastle, WY 82701-3037
Phone: (307) 746-4560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence #SP-391 (WY)

Record details

NPI number1063661916
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , CCC-SLP
Sole proprietorYes
NPI enumeratedSeptember 16, 2008
Last updated in NPPESFebruary 15, 2017

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