Individual
DR. KIRSTEN E PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2389 BABYLON ST, WANTAGH, NY 11793-4501
(917) 991-1042
Mailing address
2389 BABYLON ST, WANTAGH, NY 11793-4501
(917) 991-1042
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021715
NY
103TC0700X
Clinical Psychologist
P95464
NY
Other
Enumeration date
03/04/2015
Last updated
10/09/2020
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