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NPI Code Detail

MEDICARE: HALEY PETERSON

MEDICARE: HALEY PETERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1316806185
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY PETERSON
Provider Business Mailing Address
First Line : 12637 S 265 W
Second Line :
City : DRAPER
State : UT
Zip : 84020-5400
Country : US
Telephone Number : 801-998-8428
Fax Number :
Provider Business Practice Location Address
First Line : 12637 S 265 W
Second Line :
City : DRAPER
State : UT
Zip : 84020-5400
Country : US
Telephone Number : 801-998-8428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ HALEY PETERSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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