Individual
ADAM DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3200 VINE STREET, OFFICE B125A, CINCINNATI, OH 45220
(513) 861-3100
Mailing address
3200 VINE ST OFC B125A, CINCINNATI, OH 45220-2213
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P.07609
OH
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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