Individual
MS. AMY MARIE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP, BCBA
Contact information
Practice address
3986 LILAC LN, MOUNTAIN GREEN, UT 84050-6800
(801) 876-3949
Mailing address
3986 LILAC LN, MOUNTAIN GREEN, UT 84050-6800
(801) 876-3949
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7242
UT
235Z00000X
Speech-Language Pathologist
09138092
UT
Other
Enumeration date
07/11/2010
Last updated
07/11/2010
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