Organization
PETERSON PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE PETERSON PH.D. (CLINICAL PSYCHOLOGIST)
(803) 779-3548
Entity
Organization
Contact information
Practice address
125 ALPINE CIR, COLUMBIA, SC 29223-6385
(803) 779-3548
Mailing address
125 ALPINE CIR, COLUMBIA, SC 29223-6385
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1271
SC
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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