Individual
ALEXIS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 TECH BLVD STE 122, TAMPA, FL 33619-7822
(185) 583-2672
Mailing address
217 S MATANZAS AVE, TAMPA, FL 33609-3010
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-22-13749
FL
103K00000X
Behavior Analyst
Primary
0-23-65017
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/25/2019
Last updated
04/10/2023
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