Individual
LAURA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 GARDEN DR, SOUTH PLAINFIELD, NJ 07080-2952
(973) 220-6094
Mailing address
155 GARDEN DR, SOUTH PLAINFIELD, NJ 07080-2952
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/02/2017
Last updated
12/02/2017
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