Individual
DR. JEFFERY J PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11707 CLUB DR, TAMPA MHBS CLINIC / OPC, TAMPA, FL 33612-5521
(813) 631-7121
Mailing address
11707 CLUB DR, TAMPA MHBS CLINIC / OPC, TAMPA, FL 33612-5521
(813) 631-7121
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1307
AL
Other
Enumeration date
10/17/2005
Last updated
08/30/2007
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