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Individual

MISS DONNA PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1500 14TH ST SW, SUITE 250, WILLISTON, ND 58801
(701) 334-6242
Mailing address
PO BOX 96, RAY, ND 58849-0096
(701) 568-3385

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
082344
NY
1041C0700X
Clinical Social Worker
Primary
5339
ND

Other

Enumeration date
10/26/2016
Last updated
10/26/2016
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