Individual
HOLLY RYAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
272 N BROADWAY ST STE 101, TOOELE, UT 84074-2244
(801) 771-0273
(801) 771-0221
Mailing address
272 N BROADWAY ST STE 101, TOOELE, UT 84074-2244
(801) 771-0273
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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