Individual
STEPHANIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 417-4085
Mailing address
904 30TH AVE W, WEST FARGO, ND 58078-7937
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1436
ND
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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