Individual
DR. CONNIE LYNN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
333 W NORFOLK AVE STE 201, NORFOLK, NE 68701-5221
(402) 379-2030
(402) 379-3933
Mailing address
333 W NORFOLK AVE STE 201, NORFOLK, NE 68701-5221
(402) 379-2030
(402) 379-3933
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
310
NE
103TC0700X
Clinical Psychologist
Primary
724
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10027025403
—
NE
Enumeration date
08/21/2007
Last updated
09/13/2024
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