Individual
JENELLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 COULTER BLVD, CHANHASSEN, MN 55317-5302
(952) 522-3132
Mailing address
2025 COULTER BLVD, CHANHASSEN, MN 55317-5302
(952) 522-3132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/04/2017
Last updated
10/31/2021
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