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Individual

DR. KATHLEEN MICHELLE PETERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
202 WATER ST STE 208, EXCELSIOR, MN 55331-1887
(612) 615-3575
Mailing address
202 WATER ST STE 208, EXCELSIOR, MN 55331-1887
(612) 615-3575

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
5567
MN

Other

Enumeration date
04/25/2022
Last updated
04/25/2022
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