Individual
MR. PIETER CAMERON VANIDERSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
122 N ELM ST, SUITE 400, GREENSBORO, NC 27401-2878
(336) 334-5601
(336) 334-5657
Mailing address
122 N ELM ST, SUITE 400, GREENSBORO, NC 27401-2878
(336) 334-5601
(336) 334-5657
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1004
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1004
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3403407
—
NC
Enumeration date
09/25/2008
Last updated
09/25/2008
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