Individual
MRS. AMY A PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4501 COLEMAN ST STE 103, BISMARCK, ND 58503-0996
(701) 751-6336
(701) 751-6337
Mailing address
4530 NORTHERN SKY DR, BISMARCK, ND 58503-8534
(701) 751-6336
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1076
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55542
—
ND
Enumeration date
03/09/2012
Last updated
07/12/2019
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