Individual
MRS. KELLIE ALLISON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
112 EAST ST APT 8, CLINTON, MA 01510-1737
(508) 320-0582
Mailing address
112 EAST ST APT 8, CLINTON, MA 01510-1737
(508) 320-0582
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103
MA
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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