Individual
PEACE OBETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 NW 3RD ST, GRAND RAPIDS, MN 55744-2135
(218) 327-2001
Mailing address
2310 NW 3RD ST, GRAND RAPIDS, MN 55744-2135
(218) 327-2001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9152
OK
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200013070A
—
OK
05
—
9152
—
OK
Enumeration date
07/18/2018
Last updated
01/22/2026
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