Polly Wietzke Peterson in St Augustine - School
Polly Wietzke Peterson - NPI 1902929698
Polly Wietzke Peterson is a School in St Augustine, Florida. Polly Wietzke Peterson practices all healthcare services and medical treatments related to School. The NPI Number for Polly Wietzke Peterson is 1902929698. The last update date is 2021-03-12.
Polly Wietzke Peterson's current location address is 2465 Us Highway 1 S Unit 154, St Augustine, Florida. You can contact this provider via phone number 9047428235 and fax number 9042177222. The mailing address for Polly Wietzke Peterson is 2465 Us Highway 1 S Unit 154, St Augustine, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Polly Wietzke Peterson |
|---|---|
| Address | 2465 Us Highway 1 S Unit 154, St Augustine, Florida |
| Phone Number | 9047428235 |
| Fax Number | 9042177222 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1902929698 |
|---|---|
| Provider Enumeration Date | 2007-04-09 |
| Last Updated Date | 2021-03-12 |
Provider Mailing Address Detail
| Address | 2465 Us Highway 1 S Unit 154 |
|---|---|
| City | St Augustine |
| State | Florida (FL) |
| Post Code | 320866076 |
| Phone Number | 9047428235 |
| Fax Number | 9042177222 |
Provider's Primary Taxonomy Detail
| Speciality | School |
|---|---|
| Taxonomy | 103Ts0200X |
| Licence No | SS495 |
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Definition: A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| Z0537 | FL | BLUE CROSS BLUE SHIELD FL | |
| 346340500 | FL | US DEPARTMENT OF LABOR | |
| Z8341 | FL | BLUE CROSS BLUE SHIELD FL |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Polly Wietzke Peterson by the Centers for Medicare & Medicaid Services?
The Polly Wietzke Peterson has been assigned the NPI (National Provider Identifier) 1902929698 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Polly Wietzke Peterson's facilities are geographically located?
The facilities of Polly Wietzke Peterson are physically situated at the following location: 2465 Us Highway 1 S Unit 154, St Augustine, FL, 320866076.
What is Polly Wietzke Peterson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Polly Wietzke Peterson is School, and the taxonomy code that classifies this field of practice is 103Ts0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1902929698 to Polly Wietzke Peterson?
The Centers for Medicare & Medicaid Services originally issued the 1902929698 to Polly Wietzke Peterson on 2007-04-09.
When was the information related to Polly Wietzke Peterson most recently updated or refreshed?
The details pertaining to the Polly Wietzke Peterson, including its address, specialty, and other relevant information, were last updated or refreshed on 2021-03-12.