Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. POLLY WIETZKE PETERSON, PH.D.
Active Sole ProprietorDR. POLLY WIETZKE PETERSON, PH.D. is a School Psychologist healthcare provider located in ORANGE PARK, Florida. NPI 1902929698 is currently active in the NPPES registry. Verify at CMS.
School Psychologist · ORANGE PARK, FL
Registration Details
- NPI Number
- 1902929698
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 9, 2007 (19.349592649769 yrs)
- Last Updated
- Mar 12, 2021
- License
-
SS495 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1543 KINGSLEY AVE STE 14ORANGE PARK, FL, 320734570Browse FL providers · Browse ZIP 32073
- Phone
- 9047428164
- Fax
- 9042177222
- Primary Specialty
-
School Psychologist
103TS0200X
Other School Psychologist Providers in ORANGE PARK, FL
| Name | Credential | NPI |
|---|---|---|
| ALYSSA J PETERSON | ED.S. | 1528307212 |
| MRS. JENNY GAMBLE | SSP | 1194339994 |
| DR. VONDA ELIZABETH STATEN | PSYD | 1407619240 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.