Individual
LAWRENCE P PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
179 SULLYS TRL STE 200, PITTSFORD, NY 14534-4500
(585) 275-7301
Mailing address
601 ELMWOOD AVE BOX PSYCH, ROCHESTER, NY 14642-0001
(585) 275-7301
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
026834
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2024
Last updated
01/27/2025
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