NPI 1043976483

Mariah Anne Petersen, BCBA

Practitioner Behavior Analyst Conway, AR

Practice location

Address: 815 S Donaghey Ave, Conway, AR 72034-6880
Phone: (501) 400-0924
Mailing address: 3500 Depauw Blvd STE 3070, Indianapolis, IN 46268-6135

Registered specialties (2)

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X

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Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-21-179641 (AR)

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Registry record

NPI: 1043976483
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Nov 2021
Record last updated: 7 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.