Organization
LELAND W. PETERSEN, PSYCHOLOGIST, P.C.
Active
Other names
L.W. Petersen, Psychologist, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LELAND WALTER PETERSEN PH.D. (PRESIDENT)
(516) 671-7509
Entity
Organization
Contact information
Practice address
11 BEECHWOOD DR, GLEN HEAD, NY 11545-1101
(516) 671-7509
Mailing address
11 BEECHWOOD DR, GLEN HEAD, NY 11545-1101
(516) 671-7509
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05430
NY
Other
Enumeration date
04/19/2007
Last updated
06/17/2008
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