MR. Russell Henry Peterson, M.S.

NPI #1093879637 in Idaho Falls, Idaho

Provider Information

NPI Number: 1093879637
Entity Type: Individual
Name: MR. Russell Henry Peterson, M.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: M.S.
Enumeration Date: Dec 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2375 E SUNNYSIDE RD
Address 2: SUITE C
City: Idaho Falls
State: Idaho
ZIP Code: 83404-8280
Phone: (208) 529-5777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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