Individual
MS. COLLEEN MARIE PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
513 5TH ST SW, WILLMAR, MN 56201-3216
(320) 214-0098
(320) 214-9924
Mailing address
PO BOX 7801, SAINT CLOUD, MN 56302-7801
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1324
MN
163WP0808X
Psychiatric/Mental Health Registered Nurse
R 08429-9
MN
Other
Enumeration date
09/15/2006
Last updated
01/04/2009
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