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General NPI Number Information
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NPI Number | 1588965636
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Entity Type | Organization
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Legal Business Name | PETER T OAS PHD PA
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 707 BAYSHORE DR
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City | NICEVILLE
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State | FL
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Zip | 32578-2589
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Country | US
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Telephone | 850-729-3117
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Fax | 850-729-3142
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Provider Business Mailing Address
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Address Line | PO BOX 1002
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City | NICEVILLE
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State | FL
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Zip | 32588-1002
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Country | US
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Telephone | 850-729-3117
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Fax | 850-729-3142
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. PETER TIMOTHY OAS
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Credential | PH.D.
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Telephone | 850-729-3117
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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 | PY3598
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License Number State | FL
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