Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
Y | 103TR0400X | Rehabilitation Psychologist | PSY.0003841 | CO |
NPI | 1295978088 |
---|---|
Provider Name | Ms. Robin L. Peterson |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2009 |
Last Update Date | 20/02/2020 |