Individual
MISS DANIELLE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
110 E HARFORD ST, MILFORD, PA 18337-1002
(570) 296-5156
(570) 296-2614
Mailing address
110 E HARFORD ST, MILFORD, PA 18337-1002
(570) 296-5156
(570) 296-2614
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006967
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP006967
LICENSE
PA
Enumeration date
05/28/2015
Last updated
05/28/2015
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