NPI 1639004443

Eric Richard Petersen

Practitioner Peer Specialist Menasha, WI

Practice location

Address: 1476 Kenwood Dr STE 101, Menasha, WI 54952-1134
Phone: (920) 284-7950
Mailing address: 415 E Doty Ave, Neenah, WI 54956-2975

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1639004443
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jun 2026
Record last updated: 15 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.