Individual
JESSICA LEE DAUGHERTY-PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1043 BROOKLYN BLVD, BEREA, KY 40403-1090
(859) 779-8507
Mailing address
PO BOX 86, SANDGAP, KY 40481-0086
(859) 779-8507
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R3595
KY
Other
Enumeration date
10/03/2006
Last updated
07/15/2020
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