Individual
STEPHEN WAYNE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
7400 METRO BLVD STE 220, EDINA, MN 55439-2321
(952) 220-7164
Mailing address
8630 QUEEN AVE S, BLOOMINGTON, MN 55431-1904
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/09/2015
Last updated
05/01/2025
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