# PETERSON PSYCHOLOGICAL SERVICES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255755120
- **Authorized official:** DR. ANNA LOUISE PETERSON PH.D. (CLINICAL PSYCHOLOGIST/PRESIDENT)
- **Authorized official phone:** (502) 721-0435

## Contact information

- **Practice address:** 159 SAINT MATTHEWS AVE STE 3, LOUISVILLE, KY 40207-3137
- **Practice address phone:** (502) 721-0435
- **Practice address fax:** (502) 721-0436
- **Mailing address:** 159 SAINT MATTHEWS AVE STE 3, LOUISVILLE, KY 40207-3137
- **Mailing address phone:** (502) 721-0435
- **Mailing address fax:** (502) 721-0436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 1472 | KY | Yes |

## Other

- **Enumeration date:** 02/12/2014
- **Last updated:** 02/12/2014