Individual
MISS RYAN MAE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, CLVT
Contact information
Practice address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-6367
Mailing address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-6367
Taxonomy
Speciality
Code
Description
License number
State
225XL0004X
Low Vision Occupational Therapist
Primary
011026-1
NY
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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