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Individual

ALYSSA J PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S.

Contact information

Practice address
748 BRIAR VIEW DR, ORANGE PARK, FL 32065-3557
(310) 863-9198
Mailing address
748 BRIAR VIEW DR, ORANGE PARK, FL 32065-3557

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
104100000X
Social Worker

Other

Enumeration date
01/31/2013
Last updated
09/18/2018
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