Individual
LYNETTE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
421 DORIS AVE, JOLIET, IL 60433-2569
(815) 727-8776
(815) 774-9152
Mailing address
16413 HAROLD ST, OAK FOREST, IL 60452-4203
(708) 280-3302
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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