Individual
JAN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 WASHINGTON ST STE P55, NORWELL, MA 02061-1742
(781) 290-3886
Mailing address
1213 AVALON DR, HULL, MA 02045-3425
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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