Doctor Name: | DR. ZOE D. PETERSON |
NPI Number: | 1003033572 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 2007036382 |
Business Practice Address: | 1 University Blvd., Community Psychological Service University Of Missouri-st. Louis St. Louis, MO - 63131 |
Business Phone Number: | 3145165824 |
Business Fax Number: | |
Mailing Address: | 1 University Blvd, University Of Missouri-st. Louis SAINT LOUIS |
State: | MO |
Postal Code: | 631214400 |
Phone Number: | 3145167124 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/31/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2007036382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |