Individual
TARA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3821 W COLLEGE LN, HOBBS, NM 88242-9126
(575) 393-3168
(575) 397-4659
Mailing address
PO BOX 907, HOBBS, NM 88241-0907
(575) 393-3168
(801) 935-4946
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33393
NM
103K00000X
Behavior Analyst
11654841-2506
UT
Other
Enumeration date
01/24/2018
Last updated
07/18/2024
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