Individual
BREANNA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2540 E BENGAL BLVD STE 300, COTTONWOOD HEIGHTS, UT 84121-5157
(801) 495-5100
(801) 495-5102
Mailing address
12223 S 1740 W, RIVERTON, UT 84065-3148
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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