Provider Demographics
NPI:1154131845
Name:PETERSON, VICTORIA (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:HURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:44 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:NEW EGYPT
Mailing Address - State:NJ
Mailing Address - Zip Code:08533-1406
Mailing Address - Country:US
Mailing Address - Phone:609-752-2367
Mailing Address - Fax:
Practice Address - Street 1:40 CHRISTOPHER WAY
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3346
Practice Address - Country:US
Practice Address - Phone:732-867-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15BC00066200103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst