| Debra I.peterson Pc | |
|
300 2nd Ave Ne Suite 221 Jamestown ND 58401-3373 | |
| (701) 252-5398 | |
| (701) 252-5398 |
| Full Name | Debra I.peterson Pc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 300 2nd Ave Ne, Jamestown, North Dakota |
| Authorized Official Name and Position | Debra Irene Peterson (DIRECTOR) |
| Authorized Official Contact | 7012525398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra I.peterson Pc Po Box 874 Jamestown ND 58402-0874 Ph: (701) 252-5398 | Debra I.peterson Pc 300 2nd Ave Ne Suite 221 Jamestown ND 58401-3373 Ph: (701) 252-5398 |
| NPI Number | 1699983932 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 06/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699983932 | NPI | - | NPPES |
| 12115 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1075 (North Dakota) | Primary |
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