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NPI Code Detail

MEDICARE: DR. DONN W PETERS PSY.D.

MEDICARE: DR. DONN W PETERS PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor312303-2501UT

General Provider Information

NPI Number : 1861417875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONN W PETERS PSY.D.
Provider Business Mailing Address
First Line : 900 BITNER RD
Second Line : K-33
City : PARK CITY
State : UT
Zip : 84098-5404
Country : US
Telephone Number : 435-649-6838
Fax Number :
Provider Business Practice Location Address
First Line : 2024 SIDEWINDER DR
Second Line : SUITE 200
City : PARK CITY
State : UT
Zip : 84060-7365
Country : US
Telephone Number : 435-649-6838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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