Individual
PAMELA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 W SUPERIOR ST STE 300, DULUTH, MN 55802
(218) 722-4379
Mailing address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304004
MN
1041C0700X
Clinical Social Worker
26251
MN
Other
Enumeration date
08/09/2016
Last updated
03/15/2021
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