Individual
BERTHA MARIA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 HIBISCUS BLVD, MERRITT ISLAND, FL 32952-5070
(321) 961-7831
(407) 960-3009
Mailing address
4940 SOMERVILLE DR, ROCKLEDGE, FL 32955-6716
(423) 707-8542
(407) 960-3009
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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