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General NPI Number Information
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NPI Number | 1437186640
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Entity Type | Individual
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Provider Name | DAVID STEPHEN PETERS PH.D.,ABPP
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 73 S PALM AVE
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City | SARASOTA
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State | FL
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Zip | 34236-5638
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Country | US
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Telephone | 941-952-5200
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Fax | 941-346-8808
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Provider Business Mailing Address
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Address Line | 8108 MIDNIGHT PASS RD
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City | SARASOTA
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State | FL
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Zip | 34242-2724
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Country | US
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Telephone | 941-346-8807
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Fax | 941-346-8808
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0003752
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License Number State | FL
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