Healthcare Provider Details

I. General information

NPI: 1982390373
Provider Name (Legal Business Name): MEGAN PETERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20288 HIGHWAY 15 N STE 100
HUTCHINSON MN
55350-5685
US

IV. Provider business mailing address

329 5TH AVE SW
HUTCHINSON MN
55350-2461
US

V. Phone/Fax

Practice location:
  • Phone: 320-587-2326
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC03915
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: