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General NPI Number Information
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NPI Number | 1033135827
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Entity Type | Individual
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Provider Name | CLAY E PETERS II ED.D., L.P.C., N.C.C
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1125 STRATFORD DR
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City | BEDFORD
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State | VA
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Zip | 24523-3017
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Country | US
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Telephone | 540-314-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 STRATFORD DR
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City | BEDFORD
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State | VA
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Zip | 24523-3017
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Country | US
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Telephone | 540-314-1640
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003318
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License Number State | VA
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