Individual
MR. RICK WAYNE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
13045 FALCON DR, SUITE 100, BAXTER, MN 56425-4201
(218) 829-9307
(218) 829-7649
Mailing address
1900 SILVER LAKE NWRD 110, NEW BRIGHTON, MN 55112
(651) 379-1718
(651) 379-1738
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302318
MN
Other
Enumeration date
08/24/2009
Last updated
05/04/2015
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