Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jerry Thomas Matthew Petersen, MT-BC

Individual provider Music Therapist · NPI 1487276697

Jerry Thomas Matthew Petersen, MT-BC is a Music Therapist in Rochester, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

136 Sandbar Ct NE
Rochester, MN 55906-2652
Phone: (763) 415-0374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Music Therapist (primary) Taxonomy 225A00000X

Record details

NPI number1487276697
Entity typeIndividual (Type 1)
GenderMale
Credentials MT-BC
Sole proprietorYes
NPI enumeratedMay 11, 2020
Last updated in NPPESMay 11, 2020
Certification dateMay 11, 2020

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