| NPI | 1134627235 |
|---|---|
| Former Name | TANJA NICOLE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 2313) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-04-19 |