Organization
KEVIN H. PETERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN HOWARD PETERSON ED.D (PRESIDENT)
(301) 759-3360
Entity
Organization
Contact information
Practice address
31 BALTIMORE ST, SUITE 103, CUMBERLAND, MD 21502-3072
(301) 759-3360
(301) 759-3360
Mailing address
12517 ELLIS RD NE, CUMBERLAND, MD 21502-6876
(301) 759-3360
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
02746
MD
Other
Enumeration date
12/01/2007
Last updated
05/28/2009
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