Individual
NADINE JOANNE PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
2440 N CHARLES ST, #228, NORTH SAINT PAUL, MN 55109
(651) 307-0282
Mailing address
2440 N CHARLES ST, #228, NORTH SAINT PAUL, MN 55109
(651) 307-0282
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1003
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8122539002
—
MN
Enumeration date
10/19/2005
Last updated
07/08/2007
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