Individual
KRISTIN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26246 CRANE RD, WHITE EARTH, MN 56591-9998
(218) 983-4703
Mailing address
6578 BIG BASS RD NE, BEMIDJI, MN 56601-8674
(218) 760-6543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21218
MN
Other
Enumeration date
12/30/2016
Last updated
12/30/2016
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