Individual
MR. DAVID HEDDEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
222 9TH AVE W, ALEXANDRIA, MN 56308-2221
(320) 763-3912
(320) 763-6629
Mailing address
1304 12TH ST SE, WILLMAR, MN 56201-5437
(320) 894-3450
(320) 763-6629
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW#2185
MN
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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