Individual
DEANNA M PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAC
Contact information
Practice address
15802 N PARKVIEW PL, SURPRISE, AZ 85374-7466
(623) 523-8334
(623) 523-8311
Mailing address
1421 S 167TH DR, GOODYEAR, AZ 85338-7313
(602) 418-5422
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4374620
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4374620
SCHOOL PYSCHOLOGIST CERTIFICATION
AZ
01
—
LAC-12913
LICENSED ASSOCIATE COUNSELOR
AZ
Enumeration date
08/07/2011
Last updated
08/07/2011
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