Healthcare Provider Details

I. General information

NPI: 1831470244
Provider Name (Legal Business Name): MEAGHAN ELAINE PETERS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HAWKINS DR
IOWA CITY IA
52242-1016
US

IV. Provider business mailing address

100 HAWKINS DR
IOWA CITY IA
52242-1016
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-6274
  • Fax: 319-356-8284
Mailing address:
  • Phone: 319-384-6274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number084451
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number084451
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: