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NPI Code Detail

MEDICARE: DR. KATHRYN MARIE PETERSON PHD

MEDICARE: DR. KATHRYN MARIE PETERSON PHD
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
1103K00000XBehavior Analyst1-09-5639NJ
2103K00000XBehavior Analyst1-09-5639PA
3103K00000XBehavior Analyst1095639PA

General Provider Information

NPI Number : 1598039422
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHRYN MARIE PETERSON PHD
Provider Business Mailing Address
First Line : 1920 BRIARCLIFF RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-4010
Country : US
Telephone Number : 404-785-9400
Fax Number :
Provider Business Practice Location Address
First Line : 1920 BRIARCLIFF RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-4010
Country : US
Telephone Number : 404-785-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2012
Last Update Date : 05/05/2026

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Directions to “ DR. KATHRYN MARIE PETERSON PHD” Practice Location

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