Individual
DR. ROBERT LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
11198 GOOSE CREEK CIR, CASPER, WY 82609-4276
(307) 267-7224
Mailing address
11198 GOOSE CREEK CIR, CASPER, WY 82609-4276
(307) 267-7224
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
CSSP-18
WY
103TS0200X
School Psychologist
Primary
CSSP-18
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023346053
—
WY
05
—
116545300
—
WY
Enumeration date
01/19/2007
Last updated
01/14/2024
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