Provider Demographics
NPI:1578851507
Name:PETERS, TOWNLEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:TOWNLEY
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TOWNLEY
Other - Middle Name:
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:227 ELWA PL
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-4109
Mailing Address - Country:US
Mailing Address - Phone:415-735-8360
Mailing Address - Fax:
Practice Address - Street 1:227 ELWA PL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405
Practice Address - Country:US
Practice Address - Phone:415-735-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical