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Individual

BRIAN PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
136 EXETER PLACE DR APT 11201, SAN ANTONIO, TX 78253-4256
(210) 935-2609
Mailing address
136 EXETER PLACE DR APT 11201, SAN ANTONIO, TX 78253-4256

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
01/19/2022
Last updated
01/19/2022
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