| NPI | 1659615938 |
|---|---|
| Doing Business As | CARL V. PETERSON, PH.D. |
| Entity Type | Organization |
| Authorized Contact | CARL V. PETERSON Licensed Psychologist 541-343-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR 386) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OR 386) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |