Individual
KYE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 WAPLES MILL RD, FAIRFAX, VA 22030-7407
(703) 237-2219
Mailing address
40918 MAPLEHURST DR, ALDIE, VA 20105-2881
(540) 422-9673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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