Individual
MARJORIE MARY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2035 21 1/4 ST APT 1, RICE LAKE, WI 54868-8809
(715) 736-1673
Mailing address
2035 21 1/4 ST APT 1, RICE LAKE, WI 54868-8809
(715) 736-1673
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4678-27
WI
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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