Individual
MS. KIMBERLY ANN PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, M.S.
Contact information
Practice address
3602 CYPRESS ST STE D, WEST MONROE, LA 71291-7314
(318) 396-5210
Mailing address
114 GUMWOOD DR, WEST MONROE, LA 71291-6921
(318) 623-0587
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14844
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-14844
BACB
LA
Enumeration date
01/08/2014
Last updated
01/08/2019
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