Individual
MRS. JESSICA ANN PETERSON
Active
Individual
MRS. JESSICA ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, CSW-PIP
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20365
MN
1041C0700X
Clinical Social Worker
3028
SD
1041C0700X
Clinical Social Worker
4550
ND
Other
Enumeration date
05/24/2007
Last updated
01/14/2019
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