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Individual

BRYSON PETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AS

Contact information

Practice address
1100 9TH ST STE F, VIENNA, WV 26105-2176
(270) 772-2682
Mailing address
1100 9TH ST STE F, VIENNA, WV 26105-2176
(270) 772-2682

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
172A00000X
Driver
Primary
172V00000X
Community Health Worker
Primary

Other

Enumeration date
04/10/2025
Last updated
04/21/2026
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