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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