Individual
AVA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 S PRAIRIE DR UNIT G, SYCAMORE, IL 60178
(779) 269-4065
Mailing address
3920 WASHINGTON ST, DOWNERS GROVE, IL 60515-2127
(614) 746-0517
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-343956
IL
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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