Healthcare Provider Details

I. General information

NPI: 1609709401
Provider Name (Legal Business Name): KYLEE PETERSON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 HARRISON AVE STE C
BUTTE MT
59701-6004
US

IV. Provider business mailing address

2100 HARRISON AVE STE C
BUTTE MT
59701-6004
US

V. Phone/Fax

Practice location:
  • Phone: 406-690-6996
  • Fax: 406-206-5262
Mailing address:
  • Phone: 406-690-6996
  • Fax: 406-206-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: