Healthcare Provider Details

I. General information

NPI: 1144595059
Provider Name (Legal Business Name): DONNA PETERS PSY.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 S BELLAIRE ST STE 907
DENVER CO
80222-4304
US

IV. Provider business mailing address

1720 S BELLAIRE ST STE 907
DENVER CO
80222-4304
US

V. Phone/Fax

Practice location:
  • Phone: 303-594-7604
  • Fax: 720-529-1557
Mailing address:
  • Phone: 303-594-7604
  • Fax: 720-529-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3153
License Number StateCO

VIII. Authorized Official

Name: DR. DONNA LOUISE PETERS
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 303-594-7604