Individual
DR. KATHLEEN GERYL PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7106 DALE AVENUE, ST. LOUIS, MO 63117-1927
(314) 647-5522
(314) 827-0067
Mailing address
7106 DALE AVE, RICHMOND HEIGHTS, MO 63117-1927
(314) 647-5522
(314) 827-0067
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PYRO278
MO
Other
Enumeration date
12/29/2006
Last updated
07/12/2010
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