Individual
PETER G LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
709 KIMBARK ST, LONGMONT, CO 80501
(303) 678-7455
(303) 772-3887
Mailing address
709 KIMBARK ST, LONGMONT, CO 80501
(303) 678-7455
(303) 772-3887
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CO2011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16607376
—
CO
Enumeration date
09/01/2006
Last updated
11/06/2007
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