Polly W. Peterson, Ph.D.

LBN: Polly W. Peterson, Ph.D.
Polly W. Peterson, Ph.D. is an health care organization with primary practice located at 1543 Kingsley Ave Ste 14 , Orange Park FL 32073-4570. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Polly W. Peterson, Ph.D. can be contacted via phone (904) 742-8235, or through Peterson, Polly Wietzke via phone (904) 742-8164.

Contact Information

Primary practice address
1543 Kingsley Ave Ste 14 Orange Park FL 32073-4570
Phone: (904) 742-8235
Fax: (904) 217-7222
Website:
Map and Directions
Authorized official contact:
Name: Peterson, Polly Wietzke PHD
Phone: (904) 742-8164

Health care specialties

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

Profile Details

NPI number 1427702091
LBN Legal business name Polly W. Peterson, Ph.D.
DBA Doing business as
Authorized official Peterson, Polly Wietzke PHD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 11th, 2022
Last updated Feb 11th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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