Individual
AMELIA FLORINDA DE LA O-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
545 7TH ST W, SAINT PAUL, MN 55102-3007
(612) 767-0300
Mailing address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(952) 214-0266
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
3096
MN
Other
Enumeration date
09/23/2020
Last updated
08/07/2024
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