Individual
MR. TRENTON JON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT, LADC
Contact information
Practice address
630 E MAIN ST, ANOKA, MN 55303
(763) 712-1903
(763) 712-1917
Mailing address
630 E MAIN ST, ANOKA, MN 55303-2527
(763) 712-1903
(763) 712-1917
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1117
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687622600
—
MN
Enumeration date
10/03/2006
Last updated
07/09/2024
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