Individual
JOHN DERUYTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D
Contact information
Practice address
530 7TH AVE, FAIRBANKS, AK 99701-4971
(907) 451-8208
Mailing address
PO BOX 73511, FAIRBANKS, AK 99707-3511
(907) 451-8208
(907) 451-8207
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
547
AK
Other
Enumeration date
10/23/2006
Last updated
07/19/2019
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