Organization
DEBRA I.PETERSON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA IRENE PETERSON LAC (DIRECTOR)
(701) 252-5398
Entity
Organization
Contact information
Practice address
300 2ND AVE NE, SUITE 221, JAMESTOWN, ND 58401-3373
(701) 252-5398
(701) 252-5398
Mailing address
PO BOX 874, JAMESTOWN, ND 58402-0874
(701) 252-5398
(701) 952-5398
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1075
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12115
—
ND
Enumeration date
05/18/2007
Last updated
06/03/2008
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