Healthcare Provider Details

I. General information

NPI: 1265379507
Provider Name (Legal Business Name): ALEXANDRA PETERS BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 OLD NEW MILFORD RD
BROOKFIELD CT
06804-2430
US

IV. Provider business mailing address

169 ASPETUCK VLG
NEW MILFORD CT
06776-5625
US

V. Phone/Fax

Practice location:
  • Phone: 203-906-7842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2345
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: