Provider Demographics
NPI:1871822361
Name:PETERSON, ROBERT CURT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CURT
Last Name:PETERSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 WARM SPRINGS RD STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-6938
Mailing Address - Country:US
Mailing Address - Phone:706-221-2448
Mailing Address - Fax:706-221-2338
Practice Address - Street 1:5041 WARM SPRINGS RD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6938
Practice Address - Country:US
Practice Address - Phone:706-221-2448
Practice Address - Fax:706-221-2338
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1579103TC1900X
GAPSY003322103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling