Individual
VICTORIA ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
22616 URSA MAJOR CIR, CHUGIAK, AK 99567-5337
(805) 377-2360
Mailing address
22616 URSA MAJOR CIR, CHUGIAK, AK 99567-5337
(805) 377-2360
(805) 377-2360
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-42713
AK
Other
Enumeration date
11/08/2017
Last updated
06/16/2018
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