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General NPI Number Information
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NPI Number | 1982745592
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Entity Type | Organization
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Legal Business Name | LAURENCE P. PEROTTI, PH.D. P.C.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9119 CINNAMON HL
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City | SAN ANTONIO
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State | TX
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Zip | 78240-5401
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Country | US
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Telephone | 210-558-1102
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Fax | 210-558-1291
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Provider Business Mailing Address
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Address Line | PO BOX 171185
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City | SAN ANTONIO
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State | TX
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Zip | 78217-8185
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Country | US
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Telephone | 210-310-8864
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Fax | 210-655-4693
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURENCE PETER PEROTTI
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Credential | PH.D.
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Telephone | 210-310-8864
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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 | 2-2336
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License Number State | TX
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