Provider Demographics
NPI:1134456585
Name:PETERSON, TRISHA BIGGERS (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:BIGGERS
Last Name:PETERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 NW 13TH ST
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-5903
Mailing Address - Country:US
Mailing Address - Phone:352-375-1414
Mailing Address - Fax:
Practice Address - Street 1:3221 NW 13TH ST
Practice Address - Street 2:SUITE D-1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-5903
Practice Address - Country:US
Practice Address - Phone:352-375-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMHOO1350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health