Individual
LISA M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 745-7503
Mailing address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 745-7503
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003644A
IN
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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