| NPI | 1760965156 |
|---|---|
| Former Name | JENNIFER ANN PETERSEN |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN CC01875) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN CC01875) |
| 101YP2500X Counselor, Professional (Licence: MN CC01875) | |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2023-01-20 |