Individual
KELLY L. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7250 FRANCE AVE S, SUITE 305, EDINA, MN 55435-4305
(952) 285-2840
Mailing address
4400 BAKER RD, MINNETONKA, MN 55343-8684
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
103384
MN
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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