Makayla Bernadine Peterson

NPI #1174214324 in Coeur D Alene, Idaho

Provider Information

NPI Number: 1174214324
Entity Type: Individual
Name: Makayla Bernadine Peterson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 18, 2023
Last Updated: Jun 1, 2023

Practice Location

Address: 7905 N MEADOWLARK WAY STE C&D
City: Coeur D Alene
State: Idaho
ZIP Code: 83815-5041
Phone: (208) 618-2593

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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