Jessica E Peterson
Behavior Technician in Plymouth, MN. Individual provider (NPI-1).
NPI number1760013635
StatusActive
Last updated in NPPESJan 30, 2020
Details
- NPI
- 1760013635
- Entity type
- Individual (NPI-1)
- Name
- Jessica E Peterson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2020
- Certification date
- Jan 30, 2020
- Last updated
- Jan 30, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2600 Fernbrook Ln N Ste 138Plymouth, MN 55447-4752
Phone 952-544-0349
Mailing address
2600 Fernbrook Ln N Ste 138Plymouth, MN 55447-4752
Phone 952-544-0349
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 163 Behavior Technician providers in Plymouth · All 1,953 providers in Plymouth
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