Benjamin Bradley Peterson
Counselor, Mental Health in Fort Collins, CO. Individual provider (NPI-1).
NPI number1093563769
StatusActive
Last updated in NPPESMay 8, 2024
Details
- NPI
- 1093563769
- Entity type
- Individual (NPI-1)
- Name
- Benjamin Bradley Peterson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 8, 2024
- Certification date
- May 2, 2024
- Last updated
- May 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 171W00000X | Contractor | – | – |
Practice location
3521 Stanford Rd Apt 308-0312Fort Collins, CO 80525-4079
Phone 612-408-9870
Mailing address
3521 Stanford Rd Apt 308-0312Fort Collins, CO 80525-4079
Phone 612-408-9870
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