Individual
BETHANY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 25TH ST S, FARGO, ND 58103-2311
(701) 451-4900
(651) 925-0057
Mailing address
PO BOX 9859, FARGO, ND 58106-9859
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
2013-015A
ND
106H00000X
Marriage & Family Therapist
Primary
2018-063
ND
Other
Enumeration date
09/14/2016
Last updated
02/17/2020
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