Individual
BARBARA K PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPT. THERAPIST
Contact information
Practice address
1033 W QUINN RD, POCATELLO, ID 83202-2425
(208) 233-4800
(208) 233-4887
Mailing address
1033 W QUINN RD, POCATELLO, ID 83202-2425
(208) 233-4800
(208) 233-4887
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-884
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE #
00822
IA
Enumeration date
05/02/2006
Last updated
02/19/2015
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