Individual
MS. CAROL ANN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-5682
Mailing address
3816 47TH AVE S, MINNEAPOLIS, MN 55406-3606
(612) 724-4129
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20646
MN
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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