Individual
PETER CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
137 KENTUCKY AVE, PASADENA, MD 21122-5400
(443) 791-2645
Mailing address
137 KENTUCKY AVE, PASADENA, MD 21122-5400
(443) 791-2645
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-09-5772
MD
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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