Individual
THOMAS R. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1441 S SAINT FRANCIS DR, SANTA FE, NM 87505-4037
(505) 982-2177
(505) 982-0620
Mailing address
7910 BOSQUE ST NW, ALBUQUERQUE, NM 87114-1201
(505) 982-8870
(505) 982-0620
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0931
NM
Other
Enumeration date
08/13/2007
Last updated
02/01/2010
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