Individual
MR. KEVIN LEE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
401 16TH ST SE, ROCHESTER, MN 55904-7973
(507) 315-4184
(507) 516-0031
Mailing address
401 16TH ST SE, ROCHESTER, MN 55904-7973
(507) 315-4184
(507) 516-0031
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
00399
IA
103TC0700X
Clinical Psychologist
Primary
LP6513
MN
Other
Enumeration date
09/18/2007
Last updated
03/13/2020
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