Individual
MARIAH ANNE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
815 S DONAGHEY AVE, CONWAY, AR 72034-6880
(501) 400-0924
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
AR
106S00000X
Behavior Technician
RBT-21-179641
AR
Other
Enumeration date
11/10/2021
Last updated
12/07/2023
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