| Peterson Counseling And Supervision, Llc | |
|
1585 Thomas Center Dr 104 Eagan MN 55122-3007 | |
| (952) 808-6848 | |
| Not Available |
| Full Name | Peterson Counseling And Supervision, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1585 Thomas Center Dr, Eagan, Minnesota |
| Authorized Official Name and Position | Jessica Ann Peterson (PARTNER) |
| Authorized Official Contact | 9528086848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Counseling And Supervision, Llc 1585 Thomas Center Dr 104 Eagan MN 55122-3007 Ph: (952) 808-6848 | Peterson Counseling And Supervision, Llc 1585 Thomas Center Dr 104 Eagan MN 55122-3007 Ph: (952) 808-6848 |
| NPI Number | 1285990002 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 11/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285990002 | NPI | - | NPPES |
| 06202 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 20365 (Minnesota) | Primary |
| 251S00000X | Community/behavioral Health | 20366 (Minnesota) | Secondary |
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