Individual
MRS. BRIDGET ANN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
119 S FUQUAY AVE, FUQUAY VARINA, NC 27526-2210
(919) 557-8305
Mailing address
551 HIGHROCK LAKE RD, FUQUAY VARINA, NC 27526-3928
(707) 386-7811
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
R2541
KY
225XP0200X
Pediatric Occupational Therapist
Primary
7840
NC
225XP0200X
Pediatric Occupational Therapist
OT2372
MS
Other
Enumeration date
02/28/2007
Last updated
06/27/2011
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