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Individual

PROF. STEPHANIE MARIE PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., BCBA-D

Contact information

Practice address
11583 S. 8TH ST., SCHOOLCRAFT, MI 49087
(435) 213-0726
Mailing address
11583 S. 8TH ST., SCHOOLCRAFT, MI 49087
(435) 213-0726

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-01-0656

Other

Enumeration date
09/14/2012
Last updated
09/14/2012
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