Individual
KRISTYN M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1595 E 3300 S, SALT LAKE CITY, UT 84106-3362
(801) 548-0680
Mailing address
1595 E 3300 S, SALT LAKE CITY, UT 84106-3362
(801) 548-0680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-15-19635
UT
Other
Enumeration date
03/09/2011
Last updated
03/17/2020
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