Individual
KRISTI PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 HIGHWAY 2 W, DEVILS LAKE, ND 58301-3532
(701) 665-2200
Mailing address
524 4TH AVE NE, UNIT 19, DEVILS LAKE, ND 58301-2490
(701) 662-7050
(701) 662-3360
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3108
ND
171M00000X
Case Manager/Care Coordinator
3108
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79186
—
ND
Enumeration date
04/22/2015
Last updated
05/05/2023
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