Michelle Lee Pedersen

NPI #1588192272 in O Fallon, Illinois

Provider Information

NPI Number: 1588192272
Entity Type: Individual
Name: Michelle Lee Pedersen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: May 25, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 416 N VINE ST
City: O Fallon
State: Illinois
ZIP Code: 62269-1341
Phone: (618) 558-2849

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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