Individual
GERSON A DE PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(360) 915-6868
Mailing address
2108 104TH ST S APT N302, TACOMA, WA 98444-8105
(808) 463-7520
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
WA
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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