Individual
DENISE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 REGIMENT CT NW, ACWORTH, GA 30101-3563
(678) 777-1301
Mailing address
100 RUSSELL DR, HIRAM, GA 30141-2131
(678) 777-1301
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36331
GA
Other
Enumeration date
06/21/2019
Last updated
03/24/2021
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