Individual
DOREEN NICOSIA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 MEDIA LINE RD, NEWTOWN SQUARE, PA 19073-4602
(610) 356-7355
(610) 355-7649
Mailing address
PO BOX 419, NEWTOWN SQUARE, PA 19073-0419
(610) 356-7355
(610) 355-7649
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC007500L
PA
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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