JOHN ANTHONY PETERSEN

SOUTH BEND, IN
NPI1851491526
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: IN  20041594A)
Enumeration Date2006-09-23
Last Update Date2018-12-01
Business Address
Dr. JOHN ANTHONY PETERSEN Psy.D.
922 E WAYNE ST # 205
SOUTH BEND, IN 46617-3024
Phone number: 574-280-8199
Mailing Address
Dr. JOHN ANTHONY PETERSEN Psy.D.
208 E ANGELA BLVD
SOUTH BEND, IN 46617-1202
Phone number: 574-288-7919