Individual
DR. CHARLES ANDREW PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-3983
Mailing address
1549 ALBANY AVE, SAINT PAUL, MN 55108-2506
(651) 645-2120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0190
MN
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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