| Jonathan G. Peterson Psychiatry, Ltd. | |
|
207 Hiawatha Dr E Wabasha MN 55981-1552 | |
| (651) 564-1545 | |
| Not Available |
| Full Name | Jonathan G. Peterson Psychiatry, Ltd. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 207 Hiawatha Dr E, Wabasha, Minnesota |
| Authorized Official Name and Position | Jonathan G Peterson (PRESIDENT) |
| Authorized Official Contact | 6515641545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan G. Peterson Psychiatry, Ltd. Po Box 266 Wabasha MN 55981-0266 Ph: (651) 564-1545 | Jonathan G. Peterson Psychiatry, Ltd. 207 Hiawatha Dr E Wabasha MN 55981-1552 Ph: (651) 564-1545 |
| NPI Number | 1902164155 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 05/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902164155 | NPI | - | NPPES |
| 888268100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 33320 (Minnesota) | Primary |
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