Individual
MS. SAMANTHA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
971 E WICHITA AVE, RUSSELL, KS 67665-2444
(785) 377-4744
Mailing address
1906 TENNESSEE ST, LAWRENCE, KS 66046-2964
(785) 218-1769
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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