Individual provider · Type 1 NPI
Gary Glen Peterson, PhD
Psychologist · Ketchum, ID
Practice location
675 Sun Valley Road, C
Ketchum, ID 83340
Fax (208) 928-7666
Mailing address
PO Box 3441
Sun Valley, ID 83353-3441
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist | 103T00000X | 7790 (CA) |
| Psychologist Primary | 103T00000X | PSY 202479 (ID) |
| Psychologist | 103T00000X | 578 (AZ) |
Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…
About NPI 1114130465
Gary Glen Peterson, PhD's National Provider Identifier is 1114130465, issued on May 7, 2007. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Ketchum, ID. The record was last updated on Aug 5, 2010.