Individual
BRIANNA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9620 CHESAPEAKE DR STE 103, SAN DIEGO, CA 92123-1324
(858) 859-5369
Mailing address
2104 39TH ST, SAN DIEGO, CA 92105-5115
(308) 746-1267
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22919
CA
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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