Individual
MRS. LORENE MAE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4070
Mailing address
4519 3RD ST S, MOORHEAD, MN 56560-6729
(218) 236-8009
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
101750
MN
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
288
ND
225XN1300X
Neurorehabilitation Occupational Therapist
3838
AZ
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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