Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 58 | AK |
Y | 103G00000X | Clinical Psychologist | 58 | AK |
Y | 103TC0700X | Clinical Psychologist | 58 | AK |
N | 103TF0000X | Family Psychologist | 58 | AK |
NPI | 1376728469 |
---|---|
Provider Name | Dr. Caroline M. Peters |
First Address | Juneau, AK 99801 |
Second Address | Juneau, AK 99801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 04/05/2021 |