Doctor Name: | PETER JOSEPH SOMERS |
NPI Number: | 1063436814 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | LP1856 |
Business Practice Address: | 7225 Forestview Ln N Maple Grove, MN - 553695501 |
Business Phone Number: | 7632011090 |
Business Fax Number: | 7622011095 |
Mailing Address: | 13305 54th Ave N, PLYMOUTH |
State: | MN |
Postal Code: | 554421763 |
Phone Number: | 7635591080 |
Fax Number: | 7632011095 |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP1856 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |