Individual
BETHANY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
110 15TH ST SE, BARNESVILLE, MN 56514-3315
(218) 329-9345
Mailing address
110 15TH ST SE, BARNESVILLE, MN 56514-3315
(218) 329-9345
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
16662
MN
1041C0700X
Clinical Social Worker
Primary
3941
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19305
—
ND
Enumeration date
03/05/2012
Last updated
09/06/2022
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