Individual
KELSEY PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 HOUSTON ST STE 300, BATAVIA, IL 60510-1995
(847) 336-2237
Mailing address
1315A MODAFF RD # 6, NAPERVILLE, IL 60565-6118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
15-08503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15-08503
—
IL
Enumeration date
07/24/2018
Last updated
07/24/2018
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