Organization
CAROL B. PETERSON PH.D., L.P., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL BROOKE PETERSON PH.D. (LICENSED PSYCHOLOGIST)
(763) 595-7294
Entity
Organization
Contact information
Practice address
5101 OLSON MEMORIAL HWY, SUITE 4005, GOLDEN VALLEY, MN 55422-5149
(763) 595-7294
(763) 595-7293
Mailing address
2862 JAMES AVE S, MINNEAPOLIS, MN 55408-1822
(763) 595-7294
(763) 595-7293
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LP3201
MN
Other
Enumeration date
07/31/2006
Last updated
08/22/2020
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