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Individual

DR. F TOM PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EDD LICENSE PSYCHOLO

Contact information

Practice address
18 N 8TH STREET, #3, MILES CITY, MT 59301-0176
(406) 232-1595
(406) 232-1595
Mailing address
PO BOX 176, PETERSON PSYCHOLOGICAL SERVICES, MILES CITY, MT 59301-0176
(406) 232-1595
(406) 232-1595

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
119
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
493389
MT
01
5053
BLUE SHIELD/BC
MT
Enumeration date
10/27/2006
Last updated
07/08/2007
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