Peterson, Bonnie

Peterson, Bonnie is an individual health care provider with primary practice located at 1451 44Th Ave S , Grand Forks ND 58201-3434. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Peterson, Bonnie can be contacted via phone (701) 775-2500.

Contact Information

Primary practice address
1451 44Th Ave S Grand Forks ND 58201-3434
Phone: (701) 775-2500
Fax: (701) 787-8996
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2024 North Dakota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 11620 Minnesota

Profile Details

NPI number 1538124532
LBN Legal business name Peterson, Bonnie
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 27th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538124532 NPPES
Minnesota MEDICAID 562323500
Minnesota Other 14785
Minnesota Other 02T25RI

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