Individual
RAIZEL PHETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
11 KELLER RD, PIKESVILLE, MD 21208-1308
(410) 415-5260
Mailing address
2318 BRIGHT LEAF WAY, BALTIMORE, MD 21209-3470
(443) 760-7891
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
09248
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09248
STATE OF MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE
MD
Enumeration date
06/16/2021
Last updated
06/16/2021
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