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1275509804
GREGORY PETERSEN
ROANOKE, VA
NPI
1275509804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: VA 0810-002774)
Enumeration Date
2006-02-24
Last Update Date
2007-07-08
Business Address
-- GREGORY PETERSEN PhD
2017 JEFFERSON ST SW
ROANOKE, VA 24014-2419
Phone number: 540-981-7097
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Mailing Address
-- GREGORY PETERSEN PhD
411 WASHINGTON AVE SW
ROANOKE, VA 24016-4217
Phone number:
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