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Contact Information

JORDAN PETERSON
500 SOUTH NAVAJO DRIVE
PAGE, AZ86040
 Phone: 928-608-4100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

School

103TS0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JORDAN PETERSON · (Female)

NPI Number 1851847578
Status Active
Credentials
Entity Individual
Enumeration date 09/01/2016
Last updated 09/01/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 4109734
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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