Peterson, J.

Peterson, J. is an sole proprietor health care provider with primary practice located at 129 East German Street Room 210, Shepherdstown WV 25443-1650. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Peterson, J. can be contacted via phone (304) 876-3766.

Contact Information

Primary practice address
129 East German Street Room 210 Shepherdstown WV 25443-1650
Phone: (304) 876-3766
Fax: (304) 876-8431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 741 West Virginia

Profile Details

NPI number 1710043211
LBN Legal business name Peterson, J.
Credentials PH.D., L.L.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2006
Last updated Feb 27th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710043211 NPPES
West Virginia MEDICAID 9480075000

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