Provider Demographics
NPI:1699922864
Name:PETRIE, DONNA GAIL (BS, AS)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:GAIL
Last Name:PETRIE
Suffix:
Gender:F
Credentials:BS, AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5223
Mailing Address - Country:US
Mailing Address - Phone:907-762-2814
Mailing Address - Fax:907-561-7093
Practice Address - Street 1:4050 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5223
Practice Address - Country:US
Practice Address - Phone:907-762-2814
Practice Address - Fax:907-561-7093
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health