Individual
TARA JADE PETERSLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1299 FARNAM ST STE 300, OMAHA, NE 68102-1857
(402) 252-8181
Mailing address
1019 TURNER BLVD APT 2, OMAHA, NE 68105-1961
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-245869
NE
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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