MR. RUSSELL PETERSON, M.S.
Counselor - Mental Health
Active
Individual
NPI: 1093879637
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Counselor - Mental Health | 101YM0800X | Yes | LCPC-3125 (ID) |
Frequently Asked Questions
NPI 1093879637 is the National Provider Identifier for MR. RUSSELL PETERSON, M.S., a Counselor - Mental Health provider located in Idaho Falls, ID. This NPI was enumerated on December 20, 2006.
MR. RUSSELL PETERSON, M.S. practices at 2375 E SUNNYSIDE RD, SUITE C, Idaho Falls, ID 83404.
Quick Facts
- NPI
- 1093879637
- Type
- Individual
- Enumerated
- Dec 20, 2006
- Last Updated
- Jul 8, 2007
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