Individual
LANI PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 LEE LN, ENOLA, PA 17025-1520
(717) 303-4393
Mailing address
820 LEE LANE, ENOLA, PA 17025-1500
(717) 303-4393
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001513
PA
Other
Enumeration date
05/20/2014
Last updated
02/13/2017
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