Doctor Name: | DR. CLAY E PETERS |
NPI Number: | 1033135827 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ED.D., L.P.C., N.C.C |
License Number: | 0701003318 |
Business Practice Address: | 1125 Stratford Dr Bedford, VA - 245233017 |
Business Phone Number: | 5403141640 |
Business Fax Number: | |
Mailing Address: | 1125 Stratford Dr, BEDFORD |
State: | VA |
Postal Code: | 245233017 |
Phone Number: | 5403141640 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701003318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |