Individual
JUDITH MARIE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
157 ROOSEVELT RD, SUITE 300, SAINT CLOUD, MN 56301-5478
(320) 240-3324
(320) 240-3339
Mailing address
PO BOX 2390, SAINT CLOUD, MN 56302-2390
(320) 650-1544
(320) 650-1528
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470024400
—
MN
Enumeration date
05/18/2009
Last updated
05/18/2009
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