Individual
LATASHA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LPCC
Contact information
Practice address
17685 JUNIPER PATH STE 303, LAKEVILLE, MN 55044-9821
(952) 214-8959
(952) 214-8960
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC00829
MN
Other
Enumeration date
10/21/2014
Last updated
06/10/2024
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