Individual
DR. POLLY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
125 W GRANITE ST STE 212, BUTTE, MT 59701-9215
(406) 560-3097
Mailing address
PO BOX 448, ANACONDA, MT 59711-0448
(406) 560-3097
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-PSY-LIC-337
MT
Other
Enumeration date
05/05/2015
Last updated
04/01/2016
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