Provider Demographics
NPI:1194882399
Name:PETERS, DONNA LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:LOUISE
Last Name:PETERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S MADISON ST STE B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3019
Mailing Address - Country:US
Mailing Address - Phone:303-594-7604
Mailing Address - Fax:303-399-0650
Practice Address - Street 1:121 S MADISON ST STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3019
Practice Address - Country:US
Practice Address - Phone:303-594-7604
Practice Address - Fax:303-399-0650
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health