Individual
MS. JOY MARIE PETERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
5353 WAYZATA BLVD STE 202, ST LOUIS PARK, MN 55416-1316
(763) 432-4072
(763) 432-4073
Mailing address
5353 WAYZATA BLVD STE 202, ST LOUIS PARK, MN 55416-1316
(763) 432-4072
(763) 432-4073
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14968
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
712687500
CADI
—
Enumeration date
05/08/2006
Last updated
12/10/2018
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