Individual
RYAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
3802A GRAND AVE S, MINNEAPOLIS, MN 55409-1233
(612) 643-1932
Mailing address
3802A GRAND AVE S, MINNEAPOLIS, MN 55409-1233
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2327
MN
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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