Individual
TANNER PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2399 ARIEL ST N STE D, SAINT PAUL, MN 55109-2202
(651) 770-1311
Mailing address
2399 ARIEL ST N STE D, SAINT PAUL, MN 55109-2202
(651) 770-1311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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