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1174018980
PETER JOHN THAXTER
FREDERICKSBURG, VA
NPI
1174018980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC2200X Psychologist, Clinical Child & Adolescent
(Licence: VA 0810006004)
Enumeration Date
2018-06-25
Last Update Date
2018-06-25
Business Address
Dr. PETER JOHN THAXTER Ph.D.
510 PRINCESS ANNE ST STE 102
FREDERICKSBURG, VA 22401-6077
Phone number: 540-698-0003
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Mailing Address
Dr. PETER JOHN THAXTER Ph.D.
8931 QUARRY RD
MANASSAS, VA 20110-5160
Phone number: 703-969-4539
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