IndividualActive
Kathleen Petersen, PHD
NPI 1609510858 · School Psychologist · Excelsior, MN
Provider details
- NPI number
- 1609510858
- Entity type
- Individual
- Primary specialty
- School PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 5567 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
202 Water St Ste 208
Excelsior, MN 55331-1887
Phone: (612) 615-3575
Approximate (ZIP-level) locationGet directions
Mailing address
202 Water St Ste 208
Excelsior, MN 55331-1887
Registry dates
- Enumerated
- 2022-04-25
- Last updated
- 2022-04-25
- Certified
- 2022-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.