| J. Peterson, Ph.d., Llc | |
|
129 East German St. Suite 210 Shepherdstown WV 25443-1650 | |
| (304) 876-3766 | |
| (304) 876-8431 |
| Full Name | J. Peterson, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 129 East German St., Shepherdstown, West Virginia |
| Authorized Official Name and Position | Joanne Peterson (PSYCHOLOGIST) |
| Authorized Official Contact | 3048763766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Peterson, Ph.d., Llc Po Box 1650 Shepherdstown WV 25443-1650 Ph: (304) 876-3766 | J. Peterson, Ph.d., Llc 129 East German St. Suite 210 Shepherdstown WV 25443-1650 Ph: (304) 876-3766 |
| NPI Number | 1891992988 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891992988 | NPI | - | NPPES |
| 9480075000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 741 (West Virginia) | Primary |
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