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Individual
JESSICA NICOLE PETERSON
Active
Individual
JESSICA NICOLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR, IBCLC
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
L-319245
TX
225X00000X
Occupational Therapist
Primary
114690
TX
Other
Enumeration date
10/03/2022
Last updated
06/26/2025
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